Old Corner Drug

LBN: West Old Corner Drug, Inc
Old Corner Drug is an health care organization with primary practice located at 200 N Main St , West TX 76691-1207. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. West Old Corner Drug, Inc can be contacted via phone (254) 826-5122, or through Niemeyer, Randy James via phone (254) 826-5122.

Contact Information

Primary practice address
200 N Main St West TX 76691-1207
Phone: (254) 826-5122
Fax: (254) 826-3768
Website:
Map and Directions
Authorized official contact:
Name: Niemeyer, Randy James PHARMD
Phone: (254) 826-5122

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1518042803
LBN Legal business name West Old Corner Drug, Inc
DBA Doing business as Old Corner Drug
Authorized official Niemeyer, Randy James PHARMD
Entity Organization
Organization subpart 1 No
Enumeration date Oct 26th, 2006
Last updated Mar 6th, 2021 - about 4 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 1518042803 NPPES
Texas MEDICAID 142315
Texas MEDICAID 16437801

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