Organization
JOHN HALSEY PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERIC PENDARVIS PHARMD (PIC)
(806) 795-8555
Entity
Organization
Contact information
Practice address
4102 24TH ST, STE 103, LUBBOCK, TX 79410-1806
(806) 795-8555
(806) 795-8555
Mailing address
4102 24TH ST, STE 103, LUBBOCK, TX 79410-1806
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
11706
TX
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
Primary
—
—
3336M0002X
Mail Order Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120624
—
TX
01
—
4526046
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
08/05/2006
Last updated
09/11/2025
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