Provider Demographics
NPI:1083700215
Name:HANEY & HANEY LLC
Entity Type:Organization
Organization Name:HANEY & HANEY LLC
Other - Org Name:NEWTON FAMILY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OPERATIONS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:TREY
Authorized Official - Middle Name:
Authorized Official - Last Name:HANEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:409-769-2406
Mailing Address - Street 1:104 W COURT ST
Mailing Address - Street 2:
Mailing Address - City:NEWTON
Mailing Address - State:TX
Mailing Address - Zip Code:75966-3249
Mailing Address - Country:US
Mailing Address - Phone:409-379-9999
Mailing Address - Fax:409-379-2542
Practice Address - Street 1:104 W COURT ST
Practice Address - Street 2:
Practice Address - City:NEWTON
Practice Address - State:TX
Practice Address - Zip Code:75966-3249
Practice Address - Country:US
Practice Address - Phone:409-379-9999
Practice Address - Fax:409-379-2542
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-05
Last Update Date:2019-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0003X, 3336L0003X
TX209063336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2095764OtherPK
TX145083Medicaid