Provider Demographics
NPI:1447729850
Name:LOUIS MORGAN DRUGS NO 4 INC
Entity type:Organization
Organization Name:LOUIS MORGAN DRUGS NO 4 INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:SAMS
Authorized Official - Suffix:
Authorized Official - Credentials:
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:903-234-9193
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:903-234-9193
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-14
Last Update Date:2025-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX140972Medicaid