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General NPI Number Information
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NPI Number | 1811611056
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Entity Type | Organization
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Legal Business Name | CHAPPELLE FIRM
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Dates
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Enumeration Date | 09/30/2022
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Last Update Date | 02/21/2023
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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 | 469-602-5028
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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 | 469-602-5078
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Fax | 469-602-5028
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Authorized Official
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Title or Position | OWNER
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Name | LATANYA CHAPPELL
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Credential | R.PH
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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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