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
—
—
3336I0012X
Institutional Pharmacy
06030
TX
3336L0003X
Long Term Care Pharmacy
Primary
—
—
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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