Provider Demographics
NPI:1235267998
Name:CHAPMAN PHARMACY INC
Entity Type:Organization
Organization Name:CHAPMAN PHARMACY INC
Other - Org Name:CHEROKEE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST AND PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MONTE
Authorized Official - Middle Name:
Authorized Official - Last Name:ETHINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:903-683-2422
Mailing Address - Street 1:181 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RUSK
Mailing Address - State:TX
Mailing Address - Zip Code:75785-1325
Mailing Address - Country:US
Mailing Address - Phone:903-683-5986
Mailing Address - Fax:903-683-1195
Practice Address - Street 1:181 S MAIN ST
Practice Address - Street 2:
Practice Address - City:RUSK
Practice Address - State:TX
Practice Address - Zip Code:75785-1325
Practice Address - Country:US
Practice Address - Phone:903-683-5986
Practice Address - Fax:903-683-1195
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-02
Last Update Date:2012-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336I0012X
TX227083336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336I0012XSuppliersPharmacyInstitutional Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4529523OtherNCPDP PROVIDER IDENTIFICATION NUMBER
TX350193Medicaid