MEDICARE: CHRISTOPHER C LONGBINE PHARMD

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	183500000X	Pharmacist	45284	TX

General Provider Information

NPI Number	:	1942700836
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER C LONGBINE PHARMD

Provider Business Mailing Address
First Line	:	5306 77TH ST
Second Line	:
City	:	LUBBOCK
State	:	TX
Zip	:	79424-2502
Country	:	US
Telephone Number	:	806-543-6335
Fax Number	:

Provider Business Practice Location Address
First Line	:	112 N UNIVERSITY AVE
Second Line	:
City	:	LUBBOCK
State	:	TX
Zip	:	79415-2822
Country	:	US
Telephone Number	:	806-763-5908
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/16/2018
Last Update Date	:	02/16/2018

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