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General NPI Number Information
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NPI Number | 1215020664
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Entity Type | Organization
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Legal Business Name | NOLEN PHARMACY INC
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Dates
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Enumeration Date | 09/30/2006
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Last Update Date | 04/01/2014
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Provider Practice Location Address
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Address Line | 700 W DICKINSON BLVD
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City | FORT STOCKTON
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State | TX
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Zip | 79735-4230
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Country | US
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Telephone | 432-336-2201
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Fax | 432-336-6646
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Provider Business Mailing Address
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Address Line | PO BOX 880
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City | FORT STOCKTON
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State | TX
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Zip | 79735-0880
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Country | US
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Telephone | 432-336-2201
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Fax | 432-336-6646
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Authorized Official
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Title or Position | STORE MANAGER
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Name | VALERIE ROSE
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Credential |
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Telephone | 432-336-2201
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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 |
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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 | 3574
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License Number State | TX
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