Organization
PANHANDLE DRUG STORE LLC
Active
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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