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General NPI Number Information
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NPI Number | 1962472290
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Entity Type | Organization
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Legal Business Name | T & W PHARMACY INC
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Dates
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Enumeration Date | 01/26/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1100 SCOTT ST
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City | WICHITA FALLS
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State | TX
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Zip | 76301-4650
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Country | US
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Telephone | 940-767-4345
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Fax | 940-767-1392
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Provider Business Mailing Address
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Address Line | 1100 SCOTT ST
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City | WICHITA FALLS
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State | TX
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Zip | 76301-4650
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Country | US
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Telephone | 940-767-4345
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Fax | 940-767-1392
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Authorized Official
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Title or Position | OWNER PHARMACIST IN CHARGE
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Name | MR. RICKY R WARDELL
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Credential | RPH
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Telephone | 940-767-4345
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 5764
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License Number State | TX
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