Easttexrx LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

27066 Issued in TX

Legal business name

EASTTEXRX LLC

Doing business as

Walker Pharmacy

Practice address

402B W Upshur
Gladewater, TX 75647

Phone

(903) 845-2573

Fax

(903) 845-2266

NPI assigned

Dec 21, 2010

Last updated

Dec 21, 2010By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Eddie Goode

Title

V.P. Easttexrx, LLC

Phone

(903) 845-2573

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Walker Pharmacy Doing business as

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1292889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292889600000",
    "number": "1578866182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402B W UPSHUR",
            "city": "GLADEWATER",
            "state": "TX",
            "postal_code": "75647",
            "telephone_number": "903-845-2573",
            "fax_number": "903-845-2266"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402B W UPSHUR",
            "city": "GLADEWATER",
            "state": "TX",
            "postal_code": "75647",
            "telephone_number": "903-845-2573",
            "fax_number": "903-845-2266"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EASTTEXRX LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-12-21",
        "last_updated": "2010-12-21",
        "status": "A",
        "authorized_official_last_name": "GOODE",
        "authorized_official_first_name": "EDDIE",
        "authorized_official_title_or_position": "V.P. EASTTEXRX, LLC",
        "authorized_official_telephone_number": "903-845-2573"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "27066",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "5902095",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Walker Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jordan Davis Corpier, RN
• Angela Brooke Cox, D.C.
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• Robert Davidson, M.D.
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• Kathleen Michelle Eudy, LVN
• Sharon Evers, M.D.
• Fannin County Hospital Authority (Legend Oaks Healthcare and Rehabilitation Center Gladewater)
• Rebecca Fenton

• Community/Retail Pharmacy in Gladewater, TX
• Providers in Gladewater, TX by specialty
• Community/Retail Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.