Provider Demographics
NPI:1235819616
Name:HAPPY HOOVES PHARMACY INCORPORATED
Entity Type:Organization
Organization Name:HAPPY HOOVES PHARMACY INCORPORATED
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:NICHOLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-922-8535
Mailing Address - Street 1:1408 SIDNEY BAKER ST
Mailing Address - Street 2:
Mailing Address - City:KERRVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:78028-2725
Mailing Address - Country:US
Mailing Address - Phone:830-999-6337
Mailing Address - Fax:
Practice Address - Street 1:1408 SIDNEY BAKER ST
Practice Address - Street 2:
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-2725
Practice Address - Country:US
Practice Address - Phone:830-999-6337
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-20
Last Update Date:2023-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy