Provider Demographics
NPI:1205918612
Name:PHARMACISTS' HOME MEDICAL INC
Entity type:Organization
Organization Name:PHARMACISTS' HOME MEDICAL INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SEC TREAS
Authorized Official - Prefix:MR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:ARTHUR
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:806-242-9300
Mailing Address - Street 1:25 MEDICAL DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-4169
Mailing Address - Country:US
Mailing Address - Phone:806-242-9300
Mailing Address - Fax:806-242-9302
Practice Address - Street 1:25 MEDICAL DR
Practice Address - Street 2:SUITE B
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-4169
Practice Address - Country:US
Practice Address - Phone:806-242-9300
Practice Address - Fax:806-242-9302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX0035509332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
530460OtherBCBS
TX017120901Medicaid
TX1160220001Medicare NSC