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NPI Code Detail

MEDICARE: VICTORIA DEGROOT PHARMD

MEDICARE: VICTORIA DEGROOT PHARMD
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
1183500000XPharmacist61118TX

General Provider Information

NPI Number : 1497367791
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICTORIA DEGROOT PHARMD
Provider Business Mailing Address
First Line : 1902 RICHMOND RD
Second Line :
City : TEXARKANA
State : TX
Zip : 75503-2425
Country : US
Telephone Number : 903-838-3988
Fax Number :
Provider Business Practice Location Address
First Line : 1902 RICHMOND RD
Second Line :
City : TEXARKANA
State : TX
Zip : 75503-2425
Country : US
Telephone Number : 903-838-3988
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/18/2020
Last Update Date : 08/18/2020

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Directions to “ VICTORIA DEGROOT PHARMD” Practice Location

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