Tackett Pharmacy And Nutrition Center
LBN: Mark A Tackett
Tackett Pharmacy And Nutrition Center is an health care organization with primary practice located at 138 College Park Dr Ste 130 , Weatherford TX 76086-6372. 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.
Mark A Tackett can be contacted via phone (817) 341-7046, or through Penny, Tara via phone (817) 341-7046.
Contact Information
Primary practice address
138 College Park Dr Ste 130
Weatherford TX 76086-6372
Phone: (817) 341-7046
Fax: (817) 341-7380
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 27110 | Texas |
| Suppliers / Compounding Pharmacy | 3336C0004X |
Profile Details
| NPI number | 1538471776 |
|---|---|
| LBN Legal business name | Mark A Tackett |
| DBA Doing business as | Tackett Pharmacy And Nutrition Center |
| Authorized official | Penny, Tara PHARM D |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jul 3rd, 2010 |
| Last updated | Jun 9th, 2016 - about 8 years ago |
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 | 1538471776 | NPPES |
| Texas | MEDICAID | 148282 | |
| Texas | Other | 2125348 |
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