=====================================================
General NPI Number Information
=====================================================
NPI Number | 1104990365
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HEALTH AND HUMAN SERVICES COMMISSION
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/20/2006
-----------------------------------------------------
Last Update Date | 01/23/2019
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3401 N UNIVERSITY AVE
-----------------------------------------------------
City | LUBBOCK
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 79415-1734
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 806-763-7041
-----------------------------------------------------
Fax | 806-741-3604
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 5396
-----------------------------------------------------
City | LUBBOCK
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 79408-5396
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 806-763-7041
-----------------------------------------------------
Fax | 806-741-3604
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ASSOCIATE COMMISSIONER
-----------------------------------------------------
Name | SCOTT SCHALCHLIN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 512-438-4689
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336L0003X
-----------------------------------------------------
Taxonomy Name | Long Term Care Pharmacy
-----------------------------------------------------
License Number | 6021
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------