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General NPI Number Information
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NPI Number | 1750889002
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Entity Type | Organization
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Legal Business Name | LIBERTY DRUGS LLC
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Dates
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Enumeration Date | 01/31/2018
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Last Update Date | 10/16/2024
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Provider Practice Location Address
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Address Line | 2411 WILLIAMS DR STE 3
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City | GEORGETOWN
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State | TX
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Zip | 78628-3261
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Country | US
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Telephone | 512-820-0101
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Fax | 512-820-1244
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Provider Business Mailing Address
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Address Line | 2411 WILLIAMS DR STE 3
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City | GEORGETOWN
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State | TX
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Zip | 78628-3271
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Country | US
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Telephone | 832-687-7167
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Fax | 512-249-7512
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MUFID NAJJAR
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Credential |
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Telephone | 512-820-0101
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 31835
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License Number State | TX
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