Provider Demographics
NPI:1326140773
Name:CHAPMAN PHARMACY INC
Entity Type:Organization
Organization Name:CHAPMAN PHARMACY INC
Other - Org Name:CHAPMAN PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:MONTE
Authorized Official - Middle Name:JAMES
Authorized Official - Last Name:ETHINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:903-683-2422
Mailing Address - Street 1:1396 N DICKINSON DR
Mailing Address - Street 2:
Mailing Address - City:RUSK
Mailing Address - State:TX
Mailing Address - Zip Code:75785-1048
Mailing Address - Country:US
Mailing Address - Phone:903-683-2422
Mailing Address - Fax:903-683-2235
Practice Address - Street 1:1396 N DICKINSON DR
Practice Address - Street 2:
Practice Address - City:RUSK
Practice Address - State:TX
Practice Address - Zip Code:75785-1048
Practice Address - Country:US
Practice Address - Phone:903-683-2422
Practice Address - Fax:903-683-2235
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-05
Last Update Date:2022-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX04510333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX148132Medicaid
4364960001Medicare ID - Type Unspecified
TX141569Medicaid