MEDICARE: A & P PHARMACY, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	332B00000X	Durable Medical Equipment & Medical Supplies	19859	TX
2	3336L0003X	Long Term Care Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013903764
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	A & P PHARMACY, INC

Provider Business Mailing Address
First Line	:	207 E BYRON NELSON BLVD
Second Line	:
City	:	ROANOKE
State	:	TX
Zip	:	76262
Country	:	US
Telephone Number	:	817-431-3110
Fax Number	:	817-491-1358

Provider Business Practice Location Address
First Line	:	207 E BYRON NELSON BLVD
Second Line	:
City	:	ROANOKE
State	:	TX
Zip	:	76262
Country	:	US
Telephone Number	:	817-431-3110
Fax Number	:	817-491-1358

Authorized Official
Title or Position	:	OFFICER
Name	:	PRAVALLIKA KALI
Credential	:
Telephone Number	:	817-431-3110

Provider Enumeration Date	:	09/27/2005
Last Update Date	:	05/19/2022

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Directions to “A & P PHARMACY, INC ” Practice Location

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