Provider Demographics
NPI:1407983984
Name:PHARCRAFT DISCOUNT PHARMACY AND CRAFT SUPPLY
Entity Type:Organization
Organization Name:PHARCRAFT DISCOUNT PHARMACY AND CRAFT SUPPLY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:W
Authorized Official - Last Name:HOCH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-793-3267
Mailing Address - Street 1:PO BOX 626
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:TX
Mailing Address - Zip Code:76527-0626
Mailing Address - Country:US
Mailing Address - Phone:254-793-3267
Mailing Address - Fax:254-793-0118
Practice Address - Street 1:211 E, MAIN ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:TX
Practice Address - Zip Code:76527-0626
Practice Address - Country:US
Practice Address - Phone:254-793-3267
Practice Address - Fax:254-793-0118
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-28
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX058093336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX143668Medicaid
TX4557039OtherNABP