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General NPI Number Information
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NPI Number | 1003911876
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Entity Type | Organization
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Legal Business Name | QUINLAN PHARMACY LLC
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Dates
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Enumeration Date | 09/14/2006
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Last Update Date | 05/23/2025
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Provider Practice Location Address
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Address Line | 733 E QUINLAN PKWY
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City | QUINLAN
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State | TX
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Zip | 75474
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Country | US
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Telephone | 903-356-2449
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Fax |
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Provider Business Mailing Address
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Address Line | 733 E QUINLAN PKWY
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City | QUINLAN
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State | TX
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Zip | 75474-8641
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Country | US
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Telephone | 903-356-2449
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Fax | 903-356-4797
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Authorized Official
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Title or Position | PRESIDENT
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Name | DANIEL CRAIG WATERS
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Credential | RPH
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Telephone | 903-356-2449
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 11057
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License Number State | TX
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