Hylands Pharmacy LLC
Organization Active NPI Community/Retail Pharmacy · Wheeler, TX
NPI 1689856593 · NPPES record last updated Oct 21, 2024
Key facts
- NPI
- 1689856593
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 26300 (TX)
- Legal business name
- HYLANDS PHARMACY LLC
- Practice address
- 108 W Oklahoma Ave
Wheeler, TX 79096 - Phone
- (806) 826-5561
- Fax
- (806) 826-5655
- NPI assigned
- Dec 3, 2007
- Organization subpart
- No
Authorized official
- Name
- Crystal McEntire
- Title
- Pic/Owner
- Phone
- (806) 826-5561
Other NPIs on the same Medicare enrollment 1
Practitioners 4
-
Glenda Pinion, PHARMD
-
Tommy Lynn Weaver, RPH
-
Abigail Ray Kliewer-Mills, PHARMD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20190904000320 | TX | Part B Supplier - Mass Immunization (Roster Biller Only) | 9931392602 |
1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Shamrock, TX; Wheeler, TX |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 26300 | TX | Yes |
| Compounding Pharmacy | 3336C0004X | |||
| Long Term Care Pharmacy | 3336L0003X |
Addresses
Primary practice location
108 W Oklahoma Ave
Wheeler, TX 79096
Mailing address
PO Box 230
Wheeler, TX 79096-0230
Phone (806) 826-5561
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 145985 | Medicaid | TX | |
| 2118797 | Other | PK |
Other names
- Hyland's Pharmacy, LLC
Other providers in Wheeler, TX
- Baiely Flynn
- Robert C Galutia
- Lindsey Paige Gillespie
- Katie Elizabeth Hathaway
- Hylands Pharmacy LLC
- Jennifer James
- Kelton Independent School District
- Lisa a Mahler Arnp PLLC
- Louie L. Mendiola MD, PA
- Lisa Ann Mahler
All providers in Wheeler, TX · Community/Retail Pharmacy in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 21, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.