MEDICARE: HILL COUNTRY DRUG LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0003X	Community/Retail Pharmacy	11852	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4572966	OTHER		NABP
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164538849
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HILL COUNTRY DRUG LLC

Provider Business Mailing Address
First Line	:	PO BOX 2229
Second Line	:
City	:	CANYON LAKE
State	:	TX
Zip	:	78133-0009
Country	:	US
Telephone Number	:	830-964-3615
Fax Number	:	830-964-2553

Provider Business Practice Location Address
First Line	:	1395 SATTLER RD
Second Line	:	STE 8
City	:	NEW BRAUNFELS
State	:	TX
Zip	:	78132-2295
Country	:	US
Telephone Number	:	830-964-3615
Fax Number	:	830-964-2553

Authorized Official
Title or Position	:	CO-OWNER
Name	:	DR. JOSEPHINE A THAN
Credential	:	PHARMD
Telephone Number	:	830-964-3615

Provider Enumeration Date	:	08/22/2006
Last Update Date	:	05/06/2020

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Directions to “HILL COUNTRY DRUG LLC ” Practice Location

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