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General NPI Number Information
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NPI Number | 1205623477
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Entity Type | Organization
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Legal Business Name | 38TH STREET PHARMACY, INC.
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Dates
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Enumeration Date | 04/22/2025
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Last Update Date | 04/22/2025
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Provider Practice Location Address
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Address Line | 711 W 38TH ST STE C3
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City | AUSTIN
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State | TX
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Zip | 78705-1126
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Country | US
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Telephone | 512-458-3784
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Fax | 512-458-0882
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Provider Business Mailing Address
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Address Line | 711 W 38TH ST STE C3
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City | AUSTIN
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State | TX
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Zip | 78705-1126
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Country | US
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Telephone | 512-576-8752
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Fax |
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Authorized Official
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Title or Position | PHARMACIST/OWNER
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Name | SANDRA NIELSON WARNKEN
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Credential |
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Telephone | 512-458-3784
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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