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General NPI Number Information
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NPI Number | 1962747915
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Entity Type | Organization
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Legal Business Name | POPS PHARMACY LLC
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Dates
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Enumeration Date | 12/03/2012
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Last Update Date | 07/14/2014
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Provider Practice Location Address
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Address Line | 11719 BEE CAVE PKWY STE 204
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City | AUSTIN
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State | TX
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Zip | 78738-6347
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Country | US
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Telephone | 512-487-5650
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Fax | 512-857-7843
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Provider Business Mailing Address
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Address Line | 11719 BEE CAVES RD STE 204
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City | BEE CAVE
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State | TX
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Zip | 78738-5539
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Country | US
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Telephone | 512-487-5650
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Fax | 512-857-7843
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | ADAM METCALF
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Credential |
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Telephone | 512-487-5650
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 29281
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License Number State | TX
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