Organization
HOUCHENS EXPRESS PHARMACY LLC
Active
Other names
Sheldon's Express Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LESLIE L BIDWELL CPHT (DIRECTOR OF PHARMACY OPERATIONS)
(270) 901-3431
Entity
Organization
Contact information
Practice address
750 W 2ND ST, JASPER, IN 47546-2650
(812) 634-7379
(812) 482-3216
Mailing address
843 FAIRVIEW AVE, BOWLING GREEN, KY 42101-4914
(270) 901-3431
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
60006383A
IN
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1536424
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
200397140A
—
IN
01
—
IN2030
MEDICARE B FLU
IN
Enumeration date
12/11/2006
Last updated
11/06/2015
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