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General NPI Number Information
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NPI Number | 1306061189
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Entity Type | Organization
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Legal Business Name | MEDICINE CHEST PHARMACY LLC
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Dates
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Enumeration Date | 04/16/2007
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Last Update Date | 12/18/2019
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Provider Practice Location Address
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Address Line | 814 MONTGOMERY ROAD
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City | GRAHAM
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State | TX
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Zip | 76450
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Country | US
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Telephone | 940-549-8360
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Fax | 940-549-8361
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Provider Business Mailing Address
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Address Line | 814 MONTGOMERY ROAD
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City | GRAHAM
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State | TX
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Zip | 76450
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Country | US
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Telephone | 940-549-8360
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Fax | 940-549-8361
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MRS. ROSEANNA LOU BOWDEN
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Credential | RPH
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Telephone | 940-549-8360
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number |
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License Number State |
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