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General NPI Number Information
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NPI Number | 1104905132
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Entity Type | Organization
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Legal Business Name | HOME RX SERVICES INC
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Dates
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Enumeration Date | 11/02/2006
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Last Update Date | 07/17/2009
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Provider Practice Location Address
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Address Line | 2012 WEST LAWTER ROAD
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City | WEATHERFORD
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State | OK
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Zip | 73096
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Country | US
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Telephone | 580-774-0232
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Fax | 580-774-1523
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Provider Business Mailing Address
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Address Line | RR 3 BOX 232A
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City | WEATHERFORD
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State | OK
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Zip | 73096
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Country | US
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Telephone | 580-774-0232
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Fax | 580-774-1523
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Authorized Official
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Title or Position | CEO
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Name | PEDRO L HUERTA JR.
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Credential | PHARMACIST
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Telephone | 580-774-0232
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 284604
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License Number State | OK
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