Provider Demographics
NPI:1578936654
Name:WESTOVER HILLS PHARMACY INC
Entity Type:Organization
Organization Name:WESTOVER HILLS PHARMACY INC
Other - Org Name:WESTOVER HILLS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SULTAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HAROON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-679-8972
Mailing Address - Street 1:9793 CULEBRA RD STE 101
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78251-3750
Mailing Address - Country:US
Mailing Address - Phone:210-684-1800
Mailing Address - Fax:210-684-1801
Practice Address - Street 1:9793 CULEBRA RD STE 101
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78251-3750
Practice Address - Country:US
Practice Address - Phone:210-684-1800
Practice Address - Fax:210-684-1801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-11
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
TX306093336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX149576Medicaid
2150594OtherPK