Provider Demographics
NPI:1346469459
Name:DANA'S PHARMACY INC.
Entity Type:Organization
Organization Name:DANA'S PHARMACY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:DANA
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:TILTON
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:806-271-3394
Mailing Address - Street 1:315 BURLINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:SPUR
Mailing Address - State:TX
Mailing Address - Zip Code:79370-2812
Mailing Address - Country:US
Mailing Address - Phone:806-271-3394
Mailing Address - Fax:806-271-3631
Practice Address - Street 1:315 BURLINGTON AVE
Practice Address - Street 2:
Practice Address - City:SPUR
Practice Address - State:TX
Practice Address - Zip Code:79370
Practice Address - Country:US
Practice Address - Phone:806-271-3394
Practice Address - Fax:806-271-3631
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-25
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX174253336C0003X, 3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX144501Medicaid
TX5468250001Medicare NSC