Andrews Prescription Shop LLC

Organization Active NPI Community/Retail Pharmacy · Andrews, TX

NPI 1790760056 · NPPES record last updated Aug 16, 2022

Key facts

NPI
1790760056
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
License
27623 (TX)
Legal business name
ANDREWS PRESCRIPTION SHOP LLC
Practice address
813 Hospital Dr
Andrews, TX 79714-3618
Phone
(432) 523-4861
Fax
(432) 524-4418
NPI assigned
Dec 9, 2005
Organization subpart
No

Authorized official

Name
Aaron Gibson, RPH
Title
Pharmacist in Charge/Owner
Phone
(432) 523-4861

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TX

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20160822002491 TX Part B Supplier - Mass Immunization (Roster Biller Only) 3375838907 Practice locations: Andrews, TX

National Provider Directory

Tax ID family
Andrews Prescription Shop LLC (2 organizations share this tax ID)

Locations

813 Hospital Dr
#876
Andrews, TX 79714

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 27623 TX Yes
Long Term Care Pharmacy 3336L0003X

Addresses

Primary practice location

813 Hospital Dr
Andrews, TX 79714-3618

Mailing address

813 Hospital Dr
Box 876
Andrews, TX 79714-3618
Phone (432) 523-4861

Other identifiers

IdentifierTypeStateIssuer
2132124OtherPK
148414MedicaidTX

Other names

  • Prescription Shop Doing business as

Other providers in Andrews, TX

All providers in Andrews, TX · Community/Retail Pharmacy in Texas

Sources for this page

Verify at the official NPI Registry.