Provider Demographics
NPI:1932180700
Name:LINDA J JENNINGS INC
Entity Type:Organization
Organization Name:LINDA J JENNINGS INC
Other - Org Name:MEDICATION STATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:JENNINGS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:972-932-6855
Mailing Address - Street 1:700 W HIGHWAY 243
Mailing Address - Street 2:
Mailing Address - City:KAUFMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75142-1859
Mailing Address - Country:US
Mailing Address - Phone:972-932-6855
Mailing Address - Fax:972-932-6840
Practice Address - Street 1:700 W HIGHWAY 243
Practice Address - Street 2:
Practice Address - City:KAUFMAN
Practice Address - State:TX
Practice Address - Zip Code:75142-1859
Practice Address - Country:US
Practice Address - Phone:972-932-6855
Practice Address - Fax:972-932-6840
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX22729333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1625188Medicaid
TX144542Medicaid
TX1625188Medicaid