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General NPI Number Information
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NPI Number | 1760602080
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Entity Type | Organization
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Legal Business Name | PALACE DRUG COMPANY
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Dates
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Enumeration Date | 04/27/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 100 N MAIN
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City | RISING STAR
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State | TX
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Zip | 76471
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Country | US
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Telephone | 254-643-3231
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Fax |
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Provider Business Mailing Address
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Address Line | 100 N MAIN
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City | RISING STAR
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State | TX
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Zip | 76471
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Country | US
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Telephone | 254-643-3231
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MISS CINDY JEWELL HOLDEN
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Credential |
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Telephone | 254-643-3231
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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 | 18920
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License Number State | TX
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