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General NPI Number Information
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NPI Number | 1245587781
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Entity Type | Organization
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Legal Business Name | TROTTS DRUG
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Dates
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Enumeration Date | 08/14/2012
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Last Update Date | 08/14/2012
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Provider Practice Location Address
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Address Line | 4122 CALL FIELD RD
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City | WICHITA FALLS
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State | TX
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Zip | 76308-2517
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Country | US
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Telephone | 940-692-1234
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Fax | 940-691-5455
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Provider Business Mailing Address
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Address Line | 4122 CALL FIELD RD
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City | WICHITA FALLS
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State | TX
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Zip | 76308-2517
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Country | US
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Telephone | 940-692-1234
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Fax | 940-691-5455
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. TOM JEFFERSON
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Credential |
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Telephone | 580-795-3176
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251F00000X
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Taxonomy Name | Home Infusion Agency
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License Number | 13370
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 13379
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License Number State | TX
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