Healthcare Provider Details

I. General information

NPI: 1952343733
Provider Name (Legal Business Name): HIGHLAND DRUG INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 05/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

504 E AVENUE E
ALPINE TX
79830-4816
US

IV. Provider business mailing address

PO BOX 538
ALPINE TX
79831-0538
US

V. Phone/Fax

Practice location:
  • Phone: 432-837-3931
  • Fax: 432-837-5033
Mailing address:
  • Phone: 432-837-3931
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number505
License Number StateTX

VIII. Authorized Official

Name: JILL JAHN
Title or Position: OWNER
Credential:
Phone: 432-837-3931