MEDICARE: PERRONE 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	3336C0003X	Community/Retail Pharmacy	01865	TX

General Provider Information

NPI Number	:	1124057997
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PERRONE PHARMACY, INC

Provider Business Mailing Address
First Line	:	3921 BENBROOK HWY
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76116-7802
Country	:	US
Telephone Number	:	817-738-2135
Fax Number	:	817-763-8784

Provider Business Practice Location Address
First Line	:	3921 BENBROOK HWY
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76116-7802
Country	:	US
Telephone Number	:	817-738-2135
Fax Number	:	817-763-8784

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MRS. PAULA PERRONE
Credential	:
Telephone Number	:	817-738-2135

Provider Enumeration Date	:	07/02/2006
Last Update Date	:	10/26/2021

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Directions to “PERRONE PHARMACY, INC ” Practice Location

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