NPI Database
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Contact Information

EAGLE LAKE DRUGSTORE
702 S MCCARTY AVE
EAGLE LAKE, TX77434-3212
 Phone: 979-234-2502
 Fax: 979-234-5005
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Augmentative Communication

261QA3000X
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for EAGLE LAKE DRUGSTORE

NPI Number 1568509974
LBN Legal business name EAGLE LAKE DRUGSTORE
Authorized official SAMMI ZARATE - (PHARMACY MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 02/01/2007
Last updated 06/12/2024 - More than a year ago
Identifiers
TX License # 11754
TX Medicaid 108467501
Other 2095769 PK
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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