Provider Demographics
NPI:1447075643
Name:KIOWA PHARMACY, INC.
Entity type:Organization
Organization Name:KIOWA PHARMACY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCESS MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RHONDA
Authorized Official - Middle Name:
Authorized Official - Last Name:HINDSLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:903-893-0677
Mailing Address - Street 1:PO BOX 2407
Mailing Address - Street 2:
Mailing Address - City:SHERMAN
Mailing Address - State:TX
Mailing Address - Zip Code:75091-2407
Mailing Address - Country:US
Mailing Address - Phone:903-893-0677
Mailing Address - Fax:
Practice Address - Street 1:1201 OLIVE ST
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:TX
Practice Address - Zip Code:76240-3501
Practice Address - Country:US
Practice Address - Phone:940-668-7384
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KIOWA PHARMACY, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-11-21
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy