| NPI | 1366682049 |
|---|---|
| Doing Business As | FONDREN FOUNDATION PHARMACY AT SMITH |
| Entity Type | Organization |
| Authorized Contact | VICTORIA NIKITIN EVP, CFO 346-426-0462 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0002X Pharmacy, Clinic Pharmacy (Licence: TX 27948) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 333600000X Pharmacy | |
| Enumeration Date | 2009-02-20 |
| Last Update Date | 2022-07-13 |