Healthcare Provider Details

I. General information

NPI: 1346469459
Provider Name (Legal Business Name): DANA'S PHARMACY INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/25/2007
Last Update Date: 08/30/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

315 BURLINGTON AVE
SPUR TX
79370
US

IV. Provider business mailing address

315 BURLINGTON AVE
SPUR TX
79370-2812
US

V. Phone/Fax

Practice location:
  • Phone: 806-271-3394
  • Fax: 806-271-3631
Mailing address:
  • Phone: 806-271-3394
  • Fax: 806-271-3631

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number17425
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number17425
License Number StateTX

VIII. Authorized Official

Name: MS. DANA SUE TILTON
Title or Position: PRESIDENT
Credential: RPH
Phone: 806-271-3394