Provider Demographics
NPI:1245567213
Name:LOPERS NEIGHBORHOOD PHARMACY INC
Entity Type:Organization
Organization Name:LOPERS NEIGHBORHOOD PHARMACY INC
Other - Org Name:K-C DRUGS #2
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER, PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:936-422-4440
Mailing Address - Street 1:PO BOX 1948
Mailing Address - Street 2:
Mailing Address - City:HEMPHILL
Mailing Address - State:TX
Mailing Address - Zip Code:75948-1948
Mailing Address - Country:US
Mailing Address - Phone:409-787-2345
Mailing Address - Fax:409-787-2346
Practice Address - Street 1:2155 WORTH ST
Practice Address - Street 2:
Practice Address - City:HEMPHILL
Practice Address - State:TX
Practice Address - Zip Code:75948-7249
Practice Address - Country:US
Practice Address - Phone:409-787-2345
Practice Address - Fax:409-787-2346
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-11
Last Update Date:2014-12-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX266563336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX146114Medicaid
2122641OtherPK