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General NPI Number Information
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NPI Number | 1306047840
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Entity Type | Organization
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Legal Business Name | ADVANCED DOCTORS PRESCRIBED PHARMACY
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Dates
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Enumeration Date | 05/31/2007
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Last Update Date | 06/12/2008
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Provider Practice Location Address
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Address Line | 4499 MEDICAL DR METHODIST PLAZA SUITE 130
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City | SAN ANTONIO
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State | TX
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Zip | 78229-3735
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Country | US
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Telephone | 210-615-3600
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Fax | 210-615-3601
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Provider Business Mailing Address
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Address Line | 4499 MEDICAL DR METHODIST PLAZA SUITE 130
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City | SAN ANTONIO
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State | TX
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Zip | 78229-3735
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Country | US
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Telephone | 210-615-3600
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Fax | 210-615-3601
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARCELLIUS IHEKWUABA ANUNOBI
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Credential | RPH PHARMACIST
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Telephone | 210-615-3600
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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 | 37743
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License Number State | TX
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