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General NPI Number Information
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NPI Number | 1619206737
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Entity Type | Organization
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Legal Business Name | FREER PHARMACY LLC
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Dates
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Enumeration Date | 12/19/2009
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Last Update Date | 06/24/2011
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Provider Practice Location Address
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Address Line | 717 E. RILEY ST. SUITE C
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City | FREER
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State | TX
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Zip | 78357-1520
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Country | US
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Telephone | 361-394-7733
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Fax | 367-394-7744
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Provider Business Mailing Address
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Address Line | PO BOX 1520
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City | FREER
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State | TX
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Zip | 78357-1520
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Country | US
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Telephone | 361-394-4433
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Fax | 367-394-7744
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Authorized Official
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Title or Position | OWNER/PIC
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Name | JOSE PENA
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Credential | RPH
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Telephone | 361-394-7733
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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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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 26728
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License Number State | TX
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