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NPI Code Detail

MEDICARE: WESTEX PHARMACY LLC

MEDICARE: WESTEX PHARMACY LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1333600000XPharmacy
23336C0003XCommunity/Retail Pharmacy31809TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12175509OTHERPK

General Provider Information

NPI Number : 1336657220
Entity Type Code : Organization
Provider Name (Legal Business Name) : WESTEX PHARMACY LLC
Provider Business Mailing Address
First Line : 601 E 7TH ST
Second Line :
City : ODESSA
State : TX
Zip : 79761-4509
Country : US
Telephone Number : 432-299-2995
Fax Number : 432-299-0070
Provider Business Practice Location Address
First Line : 601 E 7TH ST
Second Line :
City : ODESSA
State : TX
Zip : 79761-4509
Country : US
Telephone Number : 432-299-2995
Fax Number : 432-299-0070
Authorized Official
Title or Position : OWNER
Name : SYMREET MANN
Credential :
Telephone Number : 432-299-2995
Provider Enumeration Date : 01/13/2018
Last Update Date : 10/02/2019

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Directions to “WESTEX PHARMACY LLC ” Practice Location

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