Organization
MALAKOFF PRESCRIPTION SHOP, INC
Active
Other names
MALAKOFF PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LISA ANDERSON KOCIAN PHARMD (VICE-PRESIDENT)
(903) 489-1909
Entity
Organization
Contact information
Practice address
409 W ROYALL BLVD, MALAKOFF, TX 75148-9499
(903) 489-1909
(903) 489-0246
Mailing address
600 S PALESTINE ST, ATHENS, TX 75751-3323
(903) 489-1909
(903) 489-0246
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
03464
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
142904
—
TX
Enumeration date
05/19/2006
Last updated
03/10/2026
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