Provider Demographics
NPI:1982838934
Name:LOPERS NEIGHBORHOOD PHARMACY INC
Entity Type:Organization
Organization Name:LOPERS NEIGHBORHOOD PHARMACY INC
Other - Org Name:LOPER'S FAMILY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:LOPER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:936-422-4440
Mailing Address - Street 1:PO BOX 929
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77351-0016
Mailing Address - Country:US
Mailing Address - Phone:936-327-5554
Mailing Address - Fax:936-327-5564
Practice Address - Street 1:1934 U S HIGHWAY 190 W
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:TX
Practice Address - Zip Code:77351-9600
Practice Address - Country:US
Practice Address - Phone:936-327-5554
Practice Address - Fax:936-327-5564
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-06
Last Update Date:2011-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX264323336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4552116OtherNCPDP PROVIDER IDENTIFICATION NUMBER