Healthcare Provider Details

I. General information

NPI: 1245567213
Provider Name (Legal Business Name): LOPERS NEIGHBORHOOD PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/11/2009
Last Update Date: 12/31/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2155 WORTH ST
HEMPHILL TX
75948-7249
US

IV. Provider business mailing address

PO BOX 1948
HEMPHILL TX
75948-1948
US

V. Phone/Fax

Practice location:
  • Phone: 409-787-2345
  • Fax: 409-787-2346
Mailing address:
  • Phone: 409-787-2345
  • Fax: 409-787-2346

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number26656
License Number StateTX

VIII. Authorized Official

Name: JERRY LOPER
Title or Position: OWNER, PRESIDENT
Credential: RPH
Phone: 936-422-4440