| NPI | 1134501059 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | I. RANDALL CHUDNOW VP Finance 210-979-3306 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 3336C0004X Pharmacy, Compounding Pharmacy | |
| 3336I0012X Pharmacy, Institutional Pharmacy | |
| 3336L0003X Pharmacy, Long Term Care Pharmacy | |
| 3336M0002X Pharmacy, Mail Order Pharmacy (Licence: TX 30034) | |
| 3336M0003X Pharmacy, Managed Care Organization Pharmacy | |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| Enumeration Date | 2015-06-27 |
| Last Update Date | 2018-02-09 |