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NPI Code Detail

MEDICARE: FRED LYNN ALBERT RPH

MEDICARE: FRED LYNN ALBERT RPH
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
1183500000XPharmacist22022TX

General Provider Information

NPI Number : 1568798171
Entity Type Code : Individual
Provider Name (Legal Business Name) : FRED LYNN ALBERT RPH
Provider Business Mailing Address
First Line : 1775 W LOOP 281
Second Line :
City : LONGVIEW
State : TX
Zip : 75604-2734
Country : US
Telephone Number : 903-295-3526
Fax Number : 903-295-3983
Provider Business Practice Location Address
First Line : 1775 W LOOP 281
Second Line :
City : LONGVIEW
State : TX
Zip : 75604-2734
Country : US
Telephone Number : 903-295-3526
Fax Number : 903-295-3983
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2009
Last Update Date : 11/02/2009

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Directions to “ FRED LYNN ALBERT RPH” Practice Location

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