Provider Demographics
NPI:1225049810
Name:WESTERMAN DRUG OF OZONA
Entity Type:Organization
Organization Name:WESTERMAN DRUG OF OZONA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PIC OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:325-392-2608
Mailing Address - Street 1:PO BOX 880
Mailing Address - Street 2:
Mailing Address - City:OZONA
Mailing Address - State:TX
Mailing Address - Zip Code:76943-0880
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:916 AVE E
Practice Address - Street 2:
Practice Address - City:OZONA
Practice Address - State:TX
Practice Address - Zip Code:76943
Practice Address - Country:US
Practice Address - Phone:325-392-2608
Practice Address - Fax:325-392-3578
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16322333600000X
3336C0003X, 3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered333600000XSuppliersPharmacy
Not Answered3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Not Answered3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX144166Medicaid
4528002OtherOTHER ID NUMBER-COMMERCIAL NUMBER