Provider Demographics
NPI:1083754139
Name:DRIPPING SPRINGS PHARMACY LA&B, LLC
Entity Type:Organization
Organization Name:DRIPPING SPRINGS PHARMACY LA&B, LLC
Other - Org Name:DRIPPING SPRINGS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CO-OWNER, PHAMD
Authorized Official - Prefix:
Authorized Official - First Name:LYNH
Authorized Official - Middle Name:
Authorized Official - Last Name:WARNKEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-858-7935
Mailing Address - Street 1:100 COMMONS RD STE 1
Mailing Address - Street 2:
Mailing Address - City:DRIPPING SPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:78620-3966
Mailing Address - Country:US
Mailing Address - Phone:512-858-7935
Mailing Address - Fax:512-858-5411
Practice Address - Street 1:100 COMMONS RD STE 1
Practice Address - Street 2:
Practice Address - City:DRIPPING SPRINGS
Practice Address - State:TX
Practice Address - Zip Code:78620-3966
Practice Address - Country:US
Practice Address - Phone:512-858-7935
Practice Address - Fax:512-858-5411
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LA&B PHARMACY PARTNERS, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-02-07
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX240583336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX145541Medicaid
TXPH0545Medicare ID - Type UnspecifiedIMMUNIZATION BILLING
TX6022930001Medicare NSC