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Organization
HEALTH AND HUMAN SERVICES COMMISSION
Active
Organization
HEALTH AND HUMAN SERVICES COMMISSION
Active
Other names
RUSK STATE HOSPITAL PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA FAUGHT (PHARMACIST - ACTING PHARMACY DIRECT)
(903) 683-7093
Entity
Organization
Contact information
Practice address
805 N DICKINSON DR # 318, RUSK, TX 75785
(903) 683-7170
(903) 683-7996
Mailing address
PO BOX 138, 805 NORTH DICKINSON, RUSK, TX 75785
(903) 683-7170
(903) 683-5996
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336I0012X
Institutional Pharmacy
06030
TX
3336L0003X
Long Term Care Pharmacy
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
133331202
—
TX
01
—
2097694
PK
—
Enumeration date
08/07/2006
Last updated
10/21/2021
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