Provider Demographics
NPI:1689000309
Name:HILL COUNTRY APOTHECARY
Entity Type:Organization
Organization Name:HILL COUNTRY APOTHECARY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JANA
Authorized Official - Middle Name:
Authorized Official - Last Name:DOWNING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-351-9139
Mailing Address - Street 1:1310 RANCH ROAD 620 S
Mailing Address - Street 2:A-1
Mailing Address - City:LAKEWAY
Mailing Address - State:TX
Mailing Address - Zip Code:78734-6300
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1310 RANCH ROAD 620 S
Practice Address - Street 2:A-1
Practice Address - City:LAKEWAY
Practice Address - State:TX
Practice Address - Zip Code:78734-6300
Practice Address - Country:US
Practice Address - Phone:512-351-9139
Practice Address - Fax:512-366-5573
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-26
Last Update Date:2013-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX288073336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy