Provider Demographics
NPI:1255051983
Name:TWO RIVERS DRUGSTORE LLC
Entity type:Organization
Organization Name:TWO RIVERS DRUGSTORE LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:AUSTIN
Authorized Official - Last Name:PEAVY
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:225-939-7033
Mailing Address - Street 1:13565 HOOPER RD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70818-2912
Mailing Address - Country:US
Mailing Address - Phone:225-256-7373
Mailing Address - Fax:225-256-5588
Practice Address - Street 1:13565 HOOPER RD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70818-2912
Practice Address - Country:US
Practice Address - Phone:225-256-7373
Practice Address - Fax:225-256-5588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-01
Last Update Date:2025-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy