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General NPI Number Information
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NPI Number | 1881645240
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Entity Type | Organization
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Legal Business Name | STORM PHARMACY INC
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Dates
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Enumeration Date | 05/12/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3141 A 2B COLLEGE ST
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City | BEAUMONT
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State | TX
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Zip | 77701
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Country | US
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Telephone | 409-839-8700
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Fax | 409-839-8706
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Provider Business Mailing Address
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Address Line | 3141 A 2B COLLEGE ST
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City | BEAUMONT
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State | TX
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Zip | 77701
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | JESUS GONZALEZ
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Credential |
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Telephone | 832-715-2574
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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 | 24975
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License Number State | TX
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