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General NPI Number Information
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NPI Number | 1417436387
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Entity Type | Organization
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Legal Business Name | DYER DRUG STORE, INC
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Dates
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Enumeration Date | 08/10/2018
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Last Update Date | 10/28/2020
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Provider Practice Location Address
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Address Line | 133 MCKINNEY ST
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City | FARMERSVILLE
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State | TX
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Zip | 75442-2221
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Country | US
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Telephone | 972-782-6262
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Fax | 972-782-7870
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Provider Business Mailing Address
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Address Line | 133 MCKINNEY ST
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City | FARMERSVILLE
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State | TX
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Zip | 75442-2221
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Country | US
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Telephone | 972-782-6262
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Fax | 972-782-7870
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Authorized Official
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Title or Position | TREASURER
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Name | STACY EVANS HICKMAN
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Credential |
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Telephone | 972-782-6262
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 13006
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License Number State | TX
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