Healthcare Provider Details

I. General information

NPI: 1720235278
Provider Name (Legal Business Name): S AND J ALVORD PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/26/2008
Last Update Date: 08/26/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 EAST BYPASS 287 STE B
ALVORD TX
76225
US

IV. Provider business mailing address

115 EAST BYPASS 287 STE B
ALVORD TX
76225
US

V. Phone/Fax

Practice location:
  • Phone: 940-427-2801
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number26157
License Number StateTX

VIII. Authorized Official

Name: MR. JARROD LINK
Title or Position: PRESIDENT
Credential:
Phone: 940-427-2801