| NPI | 1639669005 |
|---|---|
| Doing Business As | CC PHARMACY 3 |
| Entity Type | Organization |
| Authorized Contact | WARREN DEFORGE Pharmacist 737-202-4101 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: TX 31312) |
| Additional Taxonomies | 333600000X Pharmacy |
| Enumeration Date | 2018-05-11 |
| Last Update Date | 2018-07-19 |