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NPI Code Detail

MEDICARE: CHARLES DAVID LANTRIP

MEDICARE: CHARLES DAVID LANTRIP
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
1183500000XPharmacist27070TX

General Provider Information

NPI Number : 1699263251
Entity Type Code : Individual
Provider Name (Legal Business Name) : CHARLES DAVID LANTRIP
Provider Business Mailing Address
First Line : 2010 4TH ST
Second Line :
City : BROWNWOOD
State : TX
Zip : 76801-4846
Country : US
Telephone Number : 325-660-0060
Fax Number :
Provider Business Practice Location Address
First Line : 300 E COMMERCE ST
Second Line :
City : BROWNWOOD
State : TX
Zip : 76801-1824
Country : US
Telephone Number : 325-510-3400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/28/2018
Last Update Date : 04/28/2018

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Directions to “ CHARLES DAVID LANTRIP ” Practice Location

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