NPI | 1568025112 |
---|---|
Doing Business As | TEXOMA PHARMACY |
Entity Type | Organization |
Authorized Contact | RAVIVARMA DASARRAJU Managing Member 608-556-3925 |
Organization Subpart ? | No |
Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
Enumeration Date | 2019-04-19 |
Last Update Date | 2020-03-02 |