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Organization
HASKELL DRUG STORE INC
Active
Organization
HASKELL DRUG STORE INC
Active
Other names
HASKELL CLINICAL SERVICES
Organization subpart
No
Provider details
NPI number
Authorized official
LONNIE MEREDITH (OWNER PIC)
(940) 864-2674
Entity
Organization
Contact information
Practice address
100 S AVENUE E, STE B, HASKELL, TX 79521-5711
(940) 864-2674
(940) 864-3731
Mailing address
100 S AVENUE E, STE B, HASKELL, TX 79521-5711
(940) 864-2674
(940) 864-3731
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336L0003X
Long Term Care Pharmacy
Primary
25305
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2099689
PK
—
05
—
350202
—
TX
Enumeration date
12/01/2006
Last updated
06/08/2016
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