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General NPI Number Information
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NPI Number | 1093833881
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Entity Type | Organization
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Legal Business Name | BENDY B POOLE
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 06/17/2008
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Provider Practice Location Address
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Address Line | 1214 E MOCKINGBIRD LN
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City | VICTORIA
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State | TX
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Zip | 77904-2141
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Country | US
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Telephone | 361-575-4713
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Fax | 361-573-9880
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Provider Business Mailing Address
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Address Line | 1214 E MOCKINGBIRD LN
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City | VICTORIA
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State | TX
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Zip | 77904-2141
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Country | US
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Telephone | 361-575-4713
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Fax | 361-573-9880
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Authorized Official
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Title or Position | PHARMACIST-OWNER
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Name | MR. BENDY B POOLE
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Credential | RPH
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Telephone | 361-575-4713
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 16589
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License Number State | TX
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