MEDICARE: HEALTHSCRIPTS OF AMERICA-LUBBOCK 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	3336C0004X	Compounding Pharmacy
2	333600000X	Pharmacy
3	3336C0003X	Community/Retail Pharmacy	29321	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2147078	OTHER		PK

General Provider Information

NPI Number	:	1952639445
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEALTHSCRIPTS OF AMERICA-LUBBOCK LLC

Provider Business Mailing Address
First Line	:	13020 DAIRY ASHFORD RD STE 301
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77478-3151
Country	:	US
Telephone Number	:	832-494-3210
Fax Number	:	832-770-8196

Provider Business Practice Location Address
First Line	:	5004 FRANKFORD AVE
Second Line	:	STE 119
City	:	LUBBOCK
State	:	TX
Zip	:	79424-1131
Country	:	US
Telephone Number	:	806-589-6233
Fax Number	:	844-369-9210

Authorized Official
Title or Position	:	CEO
Name	:	PAUL HENRIKSEN
Credential	:
Telephone Number	:	832-770-8194

Provider Enumeration Date	:	11/23/2009
Last Update Date	:	12/08/2015

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