Provider Demographics
NPI:1699001636
Name:SANDER'S DRUG STORE
Entity Type:Organization
Organization Name:SANDER'S DRUG STORE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:MATTHEW
Authorized Official - Last Name:YARGER
Authorized Official - Suffix:
Authorized Official - Credentials:CPHT
Authorized Official - Phone:325-762-3979
Mailing Address - Street 1:PO BOX 3116
Mailing Address - Street 2:104 S. MAIN STREET
Mailing Address - City:ALBANY
Mailing Address - State:TX
Mailing Address - Zip Code:76430-8054
Mailing Address - Country:US
Mailing Address - Phone:325-762-3979
Mailing Address - Fax:325-762-3982
Practice Address - Street 1:104 SOUTH MAIN ST.
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:TX
Practice Address - Zip Code:76430-8054
Practice Address - Country:US
Practice Address - Phone:325-762-3979
Practice Address - Fax:325-762-3982
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-27
Last Update Date:2009-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy