Organization
KCN NOVAK LLC
Active
Other names
MEDICAL PARK PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DON NOVAK RPH (OWNER)
(903) 234-8326
Entity
Organization
Contact information
Practice address
709 HOLLYBROOK DR, STE 101, LONGVIEW, TX 75605-2411
(903) 234-8326
(903) 758-3808
Mailing address
615 N 3RD ST, SUITE # 1, LONGVIEW, TX 75601-6550
(903) 234-8329
(903) 247-9513
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
15960
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
144123
—
TX
01
—
2104156
PK
—
Enumeration date
08/18/2006
Last updated
09/19/2025
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