Healthcare Provider Details

I. General information

NPI: 1205623477
Provider Name (Legal Business Name): 38TH STREET PHARMACY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2025
Last Update Date: 04/22/2025
Certification Date: 04/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 W 38TH ST STE C3
AUSTIN TX
78705-1126
US

IV. Provider business mailing address

711 W 38TH ST STE C3
AUSTIN TX
78705-1126
US

V. Phone/Fax

Practice location:
  • Phone: 512-458-3784
  • Fax: 512-458-0882
Mailing address:
  • Phone: 512-576-8752
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: SANDRA NIELSON WARNKEN
Title or Position: PHARMACIST/OWNER
Credential:
Phone: 512-458-3784