Provider Demographics
NPI:1548316854
Name:SANITARIUM DRUG CO
Entity type:Organization
Organization Name:SANITARIUM DRUG CO
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:MUFID
Authorized Official - Middle Name:
Authorized Official - Last Name:NAJJAR
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:254-883-3541
Mailing Address - Street 1:423 LIVE OAK ST
Mailing Address - Street 2:
Mailing Address - City:MARLIN
Mailing Address - State:TX
Mailing Address - Zip Code:76661-2367
Mailing Address - Country:US
Mailing Address - Phone:254-883-3541
Mailing Address - Fax:254-882-9662
Practice Address - Street 1:423 LIVE OAK ST
Practice Address - Street 2:
Practice Address - City:MARLIN
Practice Address - State:TX
Practice Address - Zip Code:76661-2367
Practice Address - Country:US
Practice Address - Phone:254-883-3541
Practice Address - Fax:254-883-9662
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-27
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail PharmacyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4510637OtherNABP
TX120670Medicaid
TXAS8974784OtherDEA
TX120670Medicaid