Organization
MAURICEVILLE PHARMACY LLC
Active
Organization
MAURICEVILLE PHARMACY LLC
Active
Other names
Mauriceville Family Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
TREY HANEY (MANAGER)
(409) 769-2406
Entity
Organization
Contact information
Practice address
10897 HWY 12, MAURICEVILLE, TX 77626
(409) 745-3784
(409) 745-5910
Mailing address
PO BOX 1149, MAURICEVILLE, TX 77626-1149
(409) 745-3784
(409) 745-5910
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
23916
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149069
—
TX
01
—
2096486
PK
—
Enumeration date
06/11/2006
Last updated
09/09/2021
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up