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General NPI Number Information
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NPI Number | 1285185249
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Entity Type | Organization
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Legal Business Name | SALFITI WICHITA FALLS PHARMACY INC.
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Dates
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Enumeration Date | 10/14/2016
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Last Update Date | 03/27/2018
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Provider Practice Location Address
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Address Line | 1013 BROOK AVE
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City | WICHITA FALLS
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State | TX
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Zip | 76301-5006
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Country | US
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Telephone | 940-723-7145
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Fax | 940-322-7062
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Provider Business Mailing Address
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Address Line | 1101 W EAGLE DR SUITE C
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City | DECATUR
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State | TX
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Zip | 76234-3721
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Country | US
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Telephone | 940-627-5400
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Fax | 940-627-0257
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Authorized Official
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Title or Position | OWNER/PHARMACIST
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Name | RAJA SALFITI
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Credential |
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Telephone | 817-532-6112
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding 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 | 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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Taxonomy #3
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 13548
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License Number State | TX
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