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General NPI Number Information
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NPI Number | 1801900899
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Entity Type | Organization
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Legal Business Name | RJMTZ PHARMACY LLC
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Dates
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Enumeration Date | 08/18/2006
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Last Update Date | 02/03/2012
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Provider Practice Location Address
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Address Line | 3201 UNIVERSITY DR E SUITE 145
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City | BRYAN
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State | TX
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Zip | 77802-3475
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Country | US
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Telephone | 979-776-0902
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Fax | 979-776-0826
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Provider Business Mailing Address
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Address Line | 3201 UNIVERSITY DR E SUITE 145
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City | BRYAN
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State | TX
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Zip | 77802-3475
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Country | US
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Telephone | 979-776-0902
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Fax | 979-776-0826
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Authorized Official
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Title or Position | OWNER
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Name | JILL MUTZ
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Credential | RPH
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Telephone | 979-776-0902
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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 | 26752
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License Number State | TX
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