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General NPI Number Information
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NPI Number | 1023414877
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Entity Type | Organization
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Legal Business Name | LMR WESTER ST PHARMACY
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Dates
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Enumeration Date | 11/06/2014
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Last Update Date | 11/06/2014
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Provider Practice Location Address
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Address Line | 511 GASLIGHT BLVD
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City | LUFKIN
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State | TX
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Zip | 75904-3127
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Country | US
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Telephone | 936-632-3833
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Fax | 936-632-2832
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Provider Business Mailing Address
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Address Line | 511 GASLIGHT BLVD
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City | LUFKIN
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State | TX
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Zip | 75904-3127
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Country | US
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Telephone | 936-632-3833
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Fax | 936-632-2832
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Authorized Official
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Title or Position | OFFICER
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Name | JILANI ASIM
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Credential |
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Telephone | 936-632-3833
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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 | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 29522
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License Number State | TX
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