City Drug Store

LBN: City Drug Store Of Jacksboro, Inc
City Drug Store is an health care organization with primary practice located at 104 E Belknap St , Jacksboro TX 76458-2401. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. City Drug Store Of Jacksboro, Inc can be contacted via phone (940) 567-5576, or through Vanvacter, Chandra Renee via phone (940) 567-5576.

Contact Information

Primary practice address
104 E Belknap St Jacksboro TX 76458-2401
Phone: (940) 567-5576
Fax: (940) 567-3815
Website:
Map and Directions
Authorized official contact:
Name: Vanvacter, Chandra Renee PHARMD
Phone: (940) 567-5576

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 139 Texas
Suppliers / Compounding Pharmacy 3336C0004X

Profile Details

NPI number 1093827909
LBN Legal business name City Drug Store Of Jacksboro, Inc
DBA Doing business as City Drug Store
Authorized official Vanvacter, Chandra Renee PHARMD
Entity Organization
Organization subpart 1 No
Enumeration date Aug 31st, 2006
Last updated Feb 19th, 2024 - about last year

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093827909 NPPES
Texas MEDICAID 120408
Texas Other 2097943

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