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General NPI Number Information
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NPI Number | 1356850010
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Entity Type | Organization
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Legal Business Name | UNITED APOTHECARY, LLC
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Dates
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Enumeration Date | 09/26/2017
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Last Update Date | 09/26/2017
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Provider Practice Location Address
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Address Line | 3005 E RENNER RD STE 120
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City | RICHARDSON
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State | TX
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Zip | 75082-3570
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Country | US
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Telephone | 888-525-2010
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Fax | 888-525-0289
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Provider Business Mailing Address
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Address Line | 9724 KINGSTON PIKE STE 1402
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City | KNOXVILLE
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State | TN
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Zip | 37922-6928
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Country | US
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Telephone | 865-696-4404
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Fax | 888-525-0289
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Authorized Official
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Title or Position | PIC
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Name | DR. RUSSELL GILBERT
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Credential | PHARMD
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Telephone | 469-441-8261
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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 | 31548
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License Number State | TX
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