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General NPI Number Information
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NPI Number | 1306426234
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Entity Type | Organization
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Legal Business Name | CROWN PHARMACY LLC
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Dates
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Enumeration Date | 04/13/2021
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Last Update Date | 08/24/2022
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Provider Practice Location Address
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Address Line | 26795 US HIGHWAY 380 E STE 800
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City | AUBREY
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State | TX
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Zip | 76227-7852
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Country | US
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Telephone | 832-439-5325
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Fax |
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Provider Business Mailing Address
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Address Line | 26795 US HIGHWAY 380 E STE 800
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City | AUBREY
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State | TX
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Zip | 76227-7852
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Country | US
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Telephone | 972-999-1772
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Fax | 972-999-1779
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | JAIRAM GORLE
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Credential |
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Telephone | 972-999-1772
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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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