Provider Demographics
NPI:1326053927
Name:AUBREY PHARMACY INC
Entity Type:Organization
Organization Name:AUBREY PHARMACY INC
Other - Org Name:AUBREY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:STEVE
Authorized Official - Middle Name:
Authorized Official - Last Name:COOMES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:940-440-0400
Mailing Address - Street 1:701 S HIGHWAY 377
Mailing Address - Street 2:
Mailing Address - City:AUBREY
Mailing Address - State:TX
Mailing Address - Zip Code:76227-5534
Mailing Address - Country:US
Mailing Address - Phone:940-440-0400
Mailing Address - Fax:940-440-0401
Practice Address - Street 1:701 S HIGHWAY 377
Practice Address - Street 2:
Practice Address - City:AUBREY
Practice Address - State:TX
Practice Address - Zip Code:76227-5534
Practice Address - Country:US
Practice Address - Phone:940-440-0400
Practice Address - Fax:940-440-0401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-30
Last Update Date:2016-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
TX243403336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX145644Medicaid
2098712OtherPK