Healthcare Provider Details

I. General information

NPI: 1326837949
Provider Name (Legal Business Name): MONAHANS PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2025
Last Update Date: 05/01/2025
Certification Date: 05/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 E 4TH ST
MONAHANS TX
79756-4018
US

IV. Provider business mailing address

801 E 4TH ST
MONAHANS TX
79756-4018
US

V. Phone/Fax

Practice location:
  • Phone: 432-943-4212
  • Fax: 432-943-7503
Mailing address:
  • Phone: 432-943-4212
  • Fax: 432-943-7503

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MAKUA OGBA
Title or Position: PIC
Credential:
Phone: 432-943-4212