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General NPI Number Information
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NPI Number | 1992178453
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Entity Type | Organization
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Legal Business Name | ABSOLUTE VETERINARY COMPOUNDING PHARMACY LLC
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Dates
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Enumeration Date | 11/05/2015
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Last Update Date | 11/01/2016
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Provider Practice Location Address
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Address Line | 2005 FORT WORTH HWY STE 100
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City | WEATHERFORD
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State | TX
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Zip | 76086-4780
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Country | US
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Telephone | 817-599-7781
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Fax |
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Provider Business Mailing Address
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Address Line | 2005 FORT WORTH HWY SUITE # 100
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City | WEATHERFORD
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State | TX
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Zip | 76086-4779
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Country | US
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Telephone | 817-599-7781
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Fax |
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Authorized Official
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Title or Position | PIC
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Name | KENDRA WRIGHT
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Credential |
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Telephone | 817-599-7781
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number | 30318
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License Number State | TX
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