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General NPI Number Information
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NPI Number | 1417551417
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Entity Type | Organization
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Legal Business Name | SPRINGWOOD PHARMACY, LLC
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Dates
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Enumeration Date | 11/30/2020
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Last Update Date | 09/30/2021
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Provider Practice Location Address
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Address Line | 6404 NURSERY DRIVE SUITE 101
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City | VICTORIA
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State | TX
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Zip | 77904
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Country | US
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Telephone | 361-894-6835
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Fax | 361-894-6836
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Provider Business Mailing Address
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Address Line | PO BOX 3484
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City | VICTORIA
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State | TX
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Zip | 77903-3484
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | DR. MELISSA TIEU
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Credential |
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Telephone | 361-894-6835
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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 |
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License Number State |
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