| NPI | 1093870719 |
|---|---|
| Doing Business As | PROVIDERX OF MIDLAND |
| Entity Type | Organization |
| Authorized Contact | TERRY ALLARD General Manager 817-797-4181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: TX 26842) |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2006-12-22 |
| Last Update Date | 2010-07-02 |