Organization
JORDAN PHARMACY INC
Active
Other names
JORDAN PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JAN PATTILLO RPH (OWNER)
(254) 386-3111
Entity
Organization
Contact information
Practice address
107 N RICE ST, HAMILTON, TX 76531-1857
(254) 386-3111
(254) 386-8844
Mailing address
107 N RICE ST, HAMILTON, TX 76531-1857
(254) 386-3111
(254) 386-8844
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
21958
TX
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0145199
—
TX
01
—
2096994
PK
—
Enumeration date
09/20/2006
Last updated
04/14/2017
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