Healthcare Provider Details

I. General information

NPI: 1780715607
Provider Name (Legal Business Name): H K A CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/09/2007
Last Update Date: 09/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 S. EDDY ST. SUITE A
PECOS TX
79772-6902
US

IV. Provider business mailing address

1010 S. EDDY SUITE A
PECOS TX
79772-6902
US

V. Phone/Fax

Practice location:
  • Phone: 432-447-2266
  • Fax: 432-447-3909
Mailing address:
  • Phone: 432-447-2266
  • Fax: 432-447-3909

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number05163
License Number StateTX

VIII. Authorized Official

Name: LEO HUNG
Title or Position: PRESIDENT
Credential: RPH
Phone: 432-447-2266