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General NPI Number Information
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NPI Number | 1225046105
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Entity Type | Organization
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Legal Business Name | FREDERICKSBURG DRUG CO
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Dates
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Enumeration Date | 08/04/2006
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Last Update Date | 08/09/2013
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Provider Practice Location Address
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Address Line | 205 W WINDCREST SUITE 160
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City | FREDERICKSBURG
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State | TX
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Zip | 78624
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Country | US
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Telephone | 830-997-2163
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Fax | 830-997-6276
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Provider Business Mailing Address
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Address Line | 205 W WINDCREST SUITE 160
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City | FREDERICKSBURG
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State | TX
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Zip | 78624
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Country | US
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Telephone | 830-997-2163
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Fax | 830-997-6276
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Authorized Official
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Title or Position | PHARMACY MANAGER/OWNER
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Name | DR. RICHARD W TERRY
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Credential |
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Telephone | 830-997-2163
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 00546
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License Number State | TX
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