Provider Demographics
NPI:1104599364
Name:SCRIPX HONEY GROVE
Entity type:Organization
Organization Name:SCRIPX HONEY GROVE
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST-IN-CHARGE
Authorized Official - Prefix:DR
Authorized Official - First Name:TIEN
Authorized Official - Middle Name:H
Authorized Official - Last Name:PHAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:817-709-7548
Mailing Address - Street 1:435 5TH ST
Mailing Address - Street 2:
Mailing Address - City:HONEY GROVE
Mailing Address - State:TX
Mailing Address - Zip Code:75446-1427
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:435 5TH ST
Practice Address - Street 2:
Practice Address - City:HONEY GROVE
Practice Address - State:TX
Practice Address - Zip Code:75446-1427
Practice Address - Country:US
Practice Address - Phone:903-378-2901
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-25
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy