| NPI | 1457627705 |
|---|---|
| Doing Business As | REVCO HEALTHCARE PHARMACY |
| Entity Type | Organization |
| Authorized Contact | GODWIN EWELIKE Pharmacist In Charge 817-307-3056 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: TX 27942) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2012-03-30 |
| Last Update Date | 2012-03-30 |