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General NPI Number Information
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NPI Number | 1104929249
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Entity Type | Organization
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Legal Business Name | MAXWELL PHARMACY INC
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Dates
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Enumeration Date | 09/06/2006
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Last Update Date | 12/22/2020
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Provider Practice Location Address
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Address Line | 626 N HWY 155
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City | FRANKSTON
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State | TX
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Zip | 75763
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Country | US
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Telephone | 903-876-2323
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Fax | 903-876-4115
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Provider Business Mailing Address
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Address Line | 626 N HWY 155 PO BOX 726
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City | FRANKSTON
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State | TX
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Zip | 75763
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Country | US
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Telephone | 903-876-2323
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Fax | 903-876-4115
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | JOSEPH M MAXWELL JR.
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Credential | R.PH.
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Telephone | 903-876-2323
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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 | 21006
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License Number State | TX
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