| NPI | 1447500590 |
|---|---|
| Doing Business As | RED RIVER LTC OF TYLER |
| Entity Type | Organization |
| Authorized Contact | DAVID BOUDREAUX President/Owner 903-792-1721 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336L0003X Pharmacy, Long Term Care Pharmacy (Licence: TX 28138) |
| Enumeration Date | 2012-09-17 |
| Last Update Date | 2022-05-31 |