Lonnie Lavaughn Meredith, RPH
Individual provider Active NPI Pharmacist · Haskell, TX
NPI 1013059203 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1013059203
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 28628 (TX)
- Practice address
- 100 S Avenue E
Haskell, TX 79521-5711 - Phone
- (940) 864-2673
- Fax
- (940) 864-3731
- NPI assigned
- Feb 13, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28628 | TX | MD | Dentist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Haskell Drug Store Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 28628 | TX | Yes |
Addresses
Primary practice location
100 S Avenue E
Haskell, TX 79521-5711
Mailing address
507 N 7TH St
Haskell, TX 79521-4507
Phone (940) 864-2673
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 28628 | Other | TX | STATE PHARMACY LICENSE |
Other providers in Haskell, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.