Provider Demographics
NPI:1548652761
Name:HUGOTON DRUG LLC
Entity type:Organization
Organization Name:HUGOTON DRUG LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:BRETT
Authorized Official - Middle Name:ALLAN
Authorized Official - Last Name:HORYNA
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:620-544-4065
Mailing Address - Street 1:531 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HUGOTON
Mailing Address - State:KS
Mailing Address - Zip Code:67951-2432
Mailing Address - Country:US
Mailing Address - Phone:620-544-4065
Mailing Address - Fax:
Practice Address - Street 1:531 S MAIN ST
Practice Address - Street 2:
Practice Address - City:HUGOTON
Practice Address - State:KS
Practice Address - Zip Code:67951-2432
Practice Address - Country:US
Practice Address - Phone:620-544-4065
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-25
Last Update Date:2019-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy