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General NPI Number Information
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NPI Number | 1548391642
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Entity Type | Organization
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Legal Business Name | REDS PHARMACY LLC
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Dates
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Enumeration Date | 03/08/2007
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Last Update Date | 03/27/2025
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Provider Practice Location Address
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Address Line | 3102 GARRETT DR
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City | PERRYTON
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State | TX
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Zip | 79070-5324
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Country | US
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Telephone | 806-435-3759
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Fax | 806-435-2740
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Provider Business Mailing Address
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Address Line | 3102 GARRETT DR
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City | PERRYTON
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State | TX
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Zip | 79070-5324
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Country | US
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Telephone | 806-435-3759
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Fax | 806-435-2740
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | DEREK GOURLEY
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Credential |
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Telephone | 806-435-3759
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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 | 28992
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License Number State | TX
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