Provider Demographics
NPI:1376657361
Name:BRITT DRUG CO
Entity Type:Organization
Organization Name:BRITT DRUG CO
Other - Org Name:BRITT DRUG CO
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRES
Authorized Official - Prefix:
Authorized Official - First Name:ALFRED
Authorized Official - Middle Name:
Authorized Official - Last Name:KLAUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-939-5738
Mailing Address - Street 1:PO BOX 30
Mailing Address - Street 2:
Mailing Address - City:BELTON
Mailing Address - State:TX
Mailing Address - Zip Code:76513-0030
Mailing Address - Country:US
Mailing Address - Phone:254-939-5738
Mailing Address - Fax:254-939-1027
Practice Address - Street 1:112 E CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:BELTON
Practice Address - State:TX
Practice Address - Zip Code:76513-3279
Practice Address - Country:US
Practice Address - Phone:254-939-5738
Practice Address - Fax:254-939-1027
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2010-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
TX021873336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4506260OtherNCPDP PROVIDER IDENTIFICATION NUMBER
TX140459Medicaid
4506260OtherNCPDP PROVIDER IDENTIFICATION NUMBER