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General NPI Number Information
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NPI Number | 1427558386
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Entity Type | Organization
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Legal Business Name | AGP PHARMACY LLC
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Dates
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Enumeration Date | 02/17/2018
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Last Update Date | 04/17/2019
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Provider Practice Location Address
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Address Line | 701 COMMERCE ST
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City | SILVERTON
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State | TX
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Zip | 79257-2565
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Country | US
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Telephone | 806-823-2109
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Fax | 806-823-2110
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Provider Business Mailing Address
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Address Line | 3200 OLTON RD STE B
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City | PLAINVIEW
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State | TX
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Zip | 79072-6653
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Country | US
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Telephone | 806-296-9000
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Fax | 806-296-9001
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | ALISA PETERS
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Credential |
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Telephone | 806-296-9000
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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 | 29529
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License Number State | TX
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