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
—
—
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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