Organization
PANHANDLE DRUG STORE LLC
Active
Other names
PANHANDLE DRUG STORE
Organization subpart
No
Provider details
NPI number
Authorized official
MARK LAND (PRESIDENT)
(806) 537-3034
Entity
Organization
Contact information
Practice address
201 MAIN STREET, PANHANDLE, TX 79068
(806) 537-3034
(806) 537-5461
Mailing address
PO BOX 1654, PANHANDLE, TX 79068-1654
(806) 537-3034
(806) 537-5461
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
26080
TX
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
144799
—
TX
01
—
2104498
PK
—
Enumeration date
01/09/2007
Last updated
06/13/2016
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