Provider Demographics
NPI:1780715607
Name:H K A CORPORATION
Entity type:Organization
Organization Name:H K A CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LEO
Authorized Official - Middle Name:
Authorized Official - Last Name:HUNG
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:432-447-2266
Mailing Address - Street 1:1010 S. EDDY
Mailing Address - Street 2:SUITE A
Mailing Address - City:PECOS
Mailing Address - State:TX
Mailing Address - Zip Code:79772-6902
Mailing Address - Country:US
Mailing Address - Phone:432-447-2266
Mailing Address - Fax:432-447-3909
Practice Address - Street 1:1010 S. EDDY ST.
Practice Address - Street 2:SUITE A
Practice Address - City:PECOS
Practice Address - State:TX
Practice Address - Zip Code:79772-6902
Practice Address - Country:US
Practice Address - Phone:432-447-2266
Practice Address - Fax:432-447-3909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-09
Last Update Date:2017-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336L0003X, 332B00000X, 333600000X
TX051633336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX141830Medicaid
4500484OtherNCPDP PROVIDER IDENTIFICATION NUMBER