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General NPI Number Information
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NPI Number | 1558828921
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Entity Type | Organization
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Legal Business Name | WAXAHACHIE PHARMACY LLC
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Dates
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Enumeration Date | 02/21/2019
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Last Update Date | 02/21/2019
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Provider Practice Location Address
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Address Line | 401 N HIGHWAY 77 STE 23B
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City | WAXAHACHIE
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State | TX
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Zip | 75165-1130
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Country | US
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Telephone | 214-980-1395
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Fax | 214-980-1396
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Provider Business Mailing Address
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Address Line | 300 BOURLAND RD APT 1524
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City | KELLER
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State | TX
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Zip | 76248-3545
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Country | US
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Telephone | 603-306-2034
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Fax |
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Authorized Official
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Title or Position | PHARMACY MANAGER
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Name | MURALIKRISHNA NARRA
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Credential | B.PHARM
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Telephone | 603-306-2034
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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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