Healthcare Provider Details

I. General information

NPI: 1093707531
Provider Name (Legal Business Name): H&M PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2005
Last Update Date: 08/12/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 S MCGEE ST
BORGER TX
79007-4020
US

IV. Provider business mailing address

102 S MCGEE ST
BORGER TX
79007-4020
US

V. Phone/Fax

Practice location:
  • Phone: 806-273-5606
  • Fax: 806-273-3272
Mailing address:
  • Phone: 806-273-5606
  • Fax: 806-273-3272

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number12066
License Number StateTX

VIII. Authorized Official

Name: MR. JOHN RICHARD MOSS
Title or Position: RPH
Credential:
Phone: 806-273-5606