Dekalb Pharmacy Llc
Pharmacy
120 W Front St, De Kalb
Texas, 75559-1308
903-667-0880 309-667-0909
Dekalb Pharmacy Llc is a Pharmacy in De Kalb, Texas. It is located at 120 W Front St, De Kalb and it's customer support contact number is 903-667-0880. The authorized person of Dekalb Pharmacy Llc is Mr. Janet J. Tidwell, R.PH. who is Co-owner of the pharmacy and his contact number is 903-667-0880. Active license number of Dekalb Pharmacy Llc is 23839 for Pharmacy in Texas. Dekalb Pharmacy Llc accepts medicare which means medicare covered patients will not be billed for any more than the Medicare deductible and coinsurance.
Dekalb Pharmacy Llc is a facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.
Pharmacy Details:
Dekalb Pharmacy Llc type, location, contact phone number and fax are as below. Patients can directly walkin to the pharmacy or can call on the below given customer support phone number for enquiries.
| Name: | Dekalb Pharmacy Llc |
| Type: | Pharmacy |
| Location: | 120 W Front St, De Kalb,
Texas, 75559-1308 |
| Phone: | 903-667-0880 |
| Fax: | 309-667-0909 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this pharmacy is as below. Person's position and contact details are also mentioned below.
| Name: | Mr. Janet J. Tidwell |
| Credentials: | R.PH. |
| Position: | Co-owner |
| Contact Number: | 903-667-0880 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details of given pharmacy are as mentioned below.
| NPI Number: | 1427052000 |
| NPI Enumeration Date: | 10 Jun, 2005 |
| NPI Last Update On: | 30 Aug, 2017 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Dekalb Pharmacy Llc are as mentioned below.
| Specialization | License Number | State | Status | |
| Pharmacy | 23839 | Texas | Primary | |
Other Medical Identifiers:
Other legacy medical identifiers of the pharmacy such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 145478 | Medicaid | Texas | |
Medicare Enrollment:
Dekalb Pharmacy Llc is enrolled in medicare and it's Pac Id, enrollment Id, registered name and type is as stated below.
| PAC ID: |
Enrollment ID: |
Org Name | Medicare Entity Type |
| 6709151855 | O20170929001021 | Dekalb Pharmacy Llc | PART B SUPPLIER - OTHER |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | 120 W Front St,
De Kalb, Texas |
| Zip: | 75559-1308 |
| Phone Number: | 903-667-0880 |
| Fax Number: | 309-667-0909 |
Patients can reach Dekalb Pharmacy Llc at
120 W Front St, De Kalb, Texas or can
call on customer care at 903-667-0880.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 December, 2025.