MEDICARE: GOODVALUE PHARMACY LLC

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	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	33980	OTHER	TX	TEXAS STATE BOARD OF PHARMACY PHARMACY LICENSE

General Provider Information

NPI Number	:	1629601489
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GOODVALUE PHARMACY LLC

Provider Business Mailing Address
First Line	:	3401 FM 3009 STE 100
Second Line	:
City	:	SCHERTZ
State	:	TX
Zip	:	78154-2711
Country	:	US
Telephone Number	:	210-903-6822
Fax Number	:	210-903-6968

Provider Business Practice Location Address
First Line	:	3795 FM 3009
Second Line	:	BLDG B SUITE 300-A
City	:	SCHERTZ
State	:	TX
Zip	:	78154-2711
Country	:	US
Telephone Number	:	210-903-6822
Fax Number	:	210-903-6968

Authorized Official
Title or Position	:	MEMBER
Name	:	AMRISH PATEL
Credential	:
Telephone Number	:	430-562-9003

Provider Enumeration Date	:	02/19/2020
Last Update Date	:	09/10/2024

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Directions to “GOODVALUE PHARMACY LLC ” Practice Location

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