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General NPI Number Information
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NPI Number | 1275962961
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Entity Type | Organization
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Legal Business Name | PATIENT FIRST CHOICE PHARMACY
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Dates
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Enumeration Date | 11/04/2013
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Last Update Date | 12/19/2013
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Provider Practice Location Address
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Address Line | 1008 MAIN ST
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City | LIBERTY
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State | TX
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Zip | 77575-3718
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Country | US
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Telephone | 936-641-9395
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Fax | 936-641-9397
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Provider Business Mailing Address
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Address Line | 1008 MAIN ST
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City | LIBERTY
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State | TX
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Zip | 77575-3718
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Country | US
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Telephone | 936-641-9395
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Fax | 936-641-9397
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Authorized Official
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Title or Position | MANAGING OFFICER
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Name | TRUMAN WARREN WARREN
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Credential |
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Telephone | 832-277-2402
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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 | 28848
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License Number State | TX
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