Provider Demographics
NPI:1912913310
Name:LOUIS MORGAN DRUGS NO 4 INC
Entity type:Organization
Organization Name:LOUIS MORGAN DRUGS NO 4 INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:ERIC
Authorized Official - Last Name:SAMS
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D , RPH
Authorized Official - Phone:903-758-6164
Mailing Address - Street 1:110 JOHNSTON ST
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:75601-3909
Mailing Address - Country:US
Mailing Address - Phone:903-758-6164
Mailing Address - Fax:903-758-1721
Practice Address - Street 1:110 JOHNSTON ST
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:TX
Practice Address - Zip Code:75601-3909
Practice Address - Country:US
Practice Address - Phone:903-758-6164
Practice Address - Fax:903-758-1721
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-31
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10283336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336L0003XSuppliersPharmacyLong Term Care PharmacyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX140972Medicaid