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General NPI Number Information
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NPI Number | 1427180454
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Entity Type | Organization
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Legal Business Name | DRUG STORE INC
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Dates
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Enumeration Date | 03/13/2007
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Last Update Date | 02/19/2010
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Provider Practice Location Address
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Address Line | 2305 W OAK ST
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City | PALESTINE
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State | TX
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Zip | 75801-4063
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Country | US
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Telephone | 903-731-4734
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Fax | 903-731-4305
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Provider Business Mailing Address
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Address Line | PO BOX 1985
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City | PALESTINE
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State | TX
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Zip | 75802-1985
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Country | US
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Telephone | 903-731-4734
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Fax | 903-731-4305
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Authorized Official
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Title or Position | PRESIDENT / PIC
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Name | GREGORY SCALAPINO
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Credential | PHRMD
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Telephone | 903-731-4734
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 15275
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License Number State | TX
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