Woody Weaver Pharmacy

LBN: Woody Weaver Pharmacy Inc
Woody Weaver Pharmacy is an health care organization with primary practice located at 2726 W Gentry Pkwy , Tyler TX 75702-1635. 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. Woody Weaver Pharmacy Inc can be contacted via phone (903) 593-2533, or through Weaver, Jackie via phone (903) 593-2533.

Contact Information

Primary practice address
2726 W Gentry Pkwy Tyler TX 75702-1635
Phone: (903) 593-2533
Fax: (903) 593-2555
Website:
Map and Directions
Authorized official contact:
Name: Weaver, Jackie
Phone: (903) 593-2533

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 1947 Texas

Profile Details

NPI number 1033109053
LBN Legal business name Woody Weaver Pharmacy Inc
DBA Doing business as Woody Weaver Pharmacy
Authorized official Weaver, Jackie
Entity Organization
Organization subpart 1 No
Enumeration date Oct 21st, 2005
Last updated Nov 15th, 2023 - about 2 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 1033109053 NPPES
Other 2096287 PK
MEDICAID 130525 PK

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