Organization
JAMES L HAILEY JR
Active
Other names
ROSEBUD PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES HAILEY RPH (OWNER)
(254) 583-2727
Entity
Organization
Contact information
Practice address
112 NORTH 4TH ST., ROSEBUD, TX 76570
(254) 583-2727
(254) 583-2038
Mailing address
PO BOX 1089, ROSEBUD, TX 76570-1089
(254) 583-2727
(254) 583-2038
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
26147
TX
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
143281
—
TX
01
—
2097398
PK
—
Enumeration date
09/06/2006
Last updated
06/17/2014
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