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General NPI Number Information
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NPI Number | 1760098511
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Entity Type | Organization
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Legal Business Name | CHAPPELLE'S APOTHECARY LLC
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Dates
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Enumeration Date | 09/17/2020
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Last Update Date | 09/17/2020
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Provider Practice Location Address
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Address Line | 117 E MAIN ST
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City | FORNEY
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State | TX
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Zip | 75126-4136
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Country | US
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Telephone | 469-602-5078
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Fax | 972-552-7864
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Provider Business Mailing Address
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Address Line | 5100 WHILTMORE DR
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City | FORNEY
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State | TX
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Zip | 75126-4151
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Country | US
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Telephone | 904-923-2789
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Fax | 972-552-7864
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Authorized Official
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Title or Position | PIC
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Name | LATANYA CHAPPELL
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Credential | RPH
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Telephone | 904-923-2789
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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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