Boomtown Drug
LBN: Fikes Boomtown Drug
Boomtown Drug is an health care organization with primary practice located at 514 S. Oklahoma Cutoff , Burkburnett TX 76354. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Community/Retail Pharmacy, Suppliers / Long Term Care Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Fikes Boomtown Drug can be contacted via phone (940) 569-5600, or through Fikes, Cory Gene via phone (940) 569-5600.
Contact Information
Primary practice address
514 S. Oklahoma Cutoff
Burkburnett TX 76354
Phone: (940) 569-5600
Fax: (940) 569-5608
Website:
Authorized official contact:
Name: Fikes, Cory Gene Doctor of Public Health (DPH)
Phone: (940) 569-5600
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 25627 | Texas |
| Suppliers / Long Term Care Pharmacy | 3336L0003X |
Profile Details
| NPI number | 1902004112 |
|---|---|
| LBN Legal business name | Fikes Boomtown Drug |
| DBA Doing business as | Boomtown Drug |
| Authorized official | Fikes, Cory Gene Doctor of Public Health (DPH) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jul 10th, 2007 |
| Last updated | Mar 7th, 2023 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1902004112 | NPPES |
| Texas | Other | 25627 | STATE LICENSE # |
| Texas | MEDICAID | 200114870A | STATE LICENSE # |
| Texas | Other | 4545351 | STATE LICENSE # |
| Texas | MEDICAID | 145823 | STATE LICENSE # |
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