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Contact Information

MAURICEVILLE PHARMACY LLC
10897 HWY 12
MAURICEVILLE, TX77626
 Phone: 409-745-3784
 Fax: 409-745-5910
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for MAURICEVILLE PHARMACY LLC

NPI Number 1851333207
LBN Legal business name MAURICEVILLE PHARMACY LLC
Authorized official TREY HANEY - (MANAGER)
Entity Organization
Organization subpart 1 No
Enumeration date 06/11/2006
Last updated 09/09/2021 - About 5 years ago
Identifiers
TX License # 23916
TX Medicaid 149069
Other 2096486 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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