Tackett Pharmacy

LBN: Tackett Pharmacy
Tackett Pharmacy is an health care organization with primary practice located at 132 El Chico Trl , Willow Park TX 76087-8865. The organization recently has only one registered license in Suppliers / Community/Retail Pharmacy, which is considered as the primary health care specialty. Tackett Pharmacy can be contacted via phone (817) 441-7046, or through Tackett, Mark Andrew via phone (817) 694-7360.

Contact Information

Primary practice address
132 El Chico Trl Willow Park TX 76087-8865
Fax: (817) 441-5731
Website:
Authorized official contact:
Name: Tackett, Mark Andrew PHARMACIST

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X 06761 Texas

Profile Details

NPI number 1215022975
LBN Legal business name Tackett Pharmacy
DBA Doing business as
Authorized official Tackett, Mark Andrew PHARMACIST
Entity Organization
Organization subpart 1 No
Enumeration date Oct 4th, 2006
Last updated Jul 21st, 2008 - about 16 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1215022975 NPPES
Texas MEDICAID 142289

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