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General NPI Number Information
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NPI Number | 1003216607
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Entity Type | Organization
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Legal Business Name | VOLUNTEER HEALTHCARE CLINIC
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Dates
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Enumeration Date | 09/02/2014
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Last Update Date | 09/02/2014
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Provider Practice Location Address
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Address Line | 4215 MEDICAL PKWY
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City | AUSTIN
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State | TX
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Zip | 78756-3309
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Country | US
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Telephone | 512-459-6002
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Fax |
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Provider Business Mailing Address
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Address Line | 4215 MEDICAL PKWY
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City | AUSTIN
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State | TX
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Zip | 78756-3309
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Country | US
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Telephone | 512-459-6002
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Fax |
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | CURTIS BURCH
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Credential |
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Telephone | 512-869-1774
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 11859
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License Number State | TX
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