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General NPI Number Information
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NPI Number | 1588752224
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Entity Type | Organization
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Legal Business Name | AUTREY I V THERAPY
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Dates
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Enumeration Date | 10/10/2006
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Last Update Date | 03/21/2012
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Provider Practice Location Address
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Address Line | 1205 CENTRAL BLVD
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City | BROWNSVILLE
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State | TX
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Zip | 78520-7531
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Country | US
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Telephone | 956-548-0801
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Fax | 956-548-0802
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Provider Business Mailing Address
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Address Line | 1205 CENTRAL BLVD
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City | BROWNSVILLE
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State | TX
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Zip | 78520-7531
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Country | US
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Telephone | 956-548-0801
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Fax | 956-548-0802
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Authorized Official
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Title or Position | PARTNER AND PHARMACIST IN CHRG
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Name | ROBERT AUTREY
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Credential | RPH
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Telephone | 956-548-0801
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding 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 | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336H0001X
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Taxonomy Name | Home Infusion Therapy Pharmacy
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number |
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License Number State |
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Taxonomy #6
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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 #7
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | 14445
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License Number State | TX
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Taxonomy #8
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 14445
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License Number State | TX
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