Provider Demographics
NPI:1912068776
Name:L & B DRUG INC
Entity type:Organization
Organization Name:L & B DRUG INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JORDAN
Authorized Official - Middle Name:DWAYNE
Authorized Official - Last Name:TALLEY
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:325-677-9191
Mailing Address - Street 1:PO BOX 2855
Mailing Address - Street 2:701 HICKORY STREET
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79604
Mailing Address - Country:US
Mailing Address - Phone:325-677-9191
Mailing Address - Fax:325-677-7203
Practice Address - Street 1:701 HICKORY ST
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79601-5005
Practice Address - Country:US
Practice Address - Phone:325-677-9191
Practice Address - Fax:325-677-7203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-13
Last Update Date:2024-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 332BX2000X, 3336C0003X
TX13385333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BX2000XSuppliersDurable Medical Equipment & Medical SuppliesOxygen Equipment & Supplies
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX13385OtherSTATE BOARD LICENSE NUMBER
TX149244Medicaid
4557914OtherNCPDP