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General NPI Number Information
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NPI Number | 1740320043
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Entity Type | Organization
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Legal Business Name | CITY DRUG OF ALPINE INC
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 202 E AVENUE E
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City | ALPINE
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State | TX
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Zip | 79830-4728
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Country | US
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Telephone | 432-837-2252
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Fax | 432-837-3152
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Provider Business Mailing Address
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Address Line | 202 E AVENUE E
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City | ALPINE
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State | TX
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Zip | 79830-4728
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Country | US
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Telephone | 432-837-2252
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Fax | 432-837-3152
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Authorized Official
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Title or Position | OWNER PHARMACIST
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Name | MR. JACK T BOW
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Credential | RPH
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Telephone | 432-837-2252
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 13739
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License Number State | TX
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