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General NPI Number Information
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NPI Number | 1316439748
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Entity Type | Organization
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Legal Business Name | AMBIKA PHARMACY LLC
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Dates
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Enumeration Date | 06/01/2018
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Last Update Date | 07/10/2019
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Provider Practice Location Address
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Address Line | 2300 MATLOCK RD STE 37
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City | MANSFIELD
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State | TX
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Zip | 76063-5018
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Country | US
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Telephone | 682-422-4421
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Fax | 682-292-1659
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Provider Business Mailing Address
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Address Line | 2300 MATLOCK RD SUITE 37
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City | MANSFIELD
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State | TX
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Zip | 76063-5019
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Country | US
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Telephone | 682-422-4421
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Fax | 682-292-1659
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Authorized Official
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Title or Position | MANAGER
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Name | SONJA R TURLEY
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Credential |
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Telephone | 817-423-3636
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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 | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 32067
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License Number State | TX
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