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General NPI Number Information
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NPI Number | 1396823274
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Entity Type | Organization
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Legal Business Name | MINYARD FOOD STORES INC.
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Dates
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Enumeration Date | 11/01/2006
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Last Update Date | 11/16/2007
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Provider Practice Location Address
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Address Line | 1909 E PARK ROW DR
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City | ARLINGTON
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State | TX
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Zip | 76010-4745
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Country | US
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Telephone | 817-548-1728
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Fax | 817-276-9283
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Provider Business Mailing Address
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Address Line | 1909 E PARK ROW DR
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City | ARLINGTON
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State | TX
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Zip | 76010-4745
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Country | US
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Telephone | 817-548-1728
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Fax | 817-276-9283
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Authorized Official
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Title or Position | PRESIDENT/CEO
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Name | MR. MICHAEL D. BYARS
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Credential |
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Telephone | 972-393-8700
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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 | 16079
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License Number State | TX
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