MEDICARE: S AND J ALVORD PHARMACY

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	26157	TX

General Provider Information

NPI Number	:	1720235278
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	S AND J ALVORD PHARMACY

Provider Business Mailing Address
First Line	:	115 EAST BYPASS 287
Second Line	:	STE B
City	:	ALVORD
State	:	TX
Zip	:	76225
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	115 EAST BYPASS 287
Second Line	:	STE B
City	:	ALVORD
State	:	TX
Zip	:	76225
Country	:	US
Telephone Number	:	940-427-2801
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	MR. JARROD LINK
Credential	:
Telephone Number	:	940-427-2801

Provider Enumeration Date	:	08/26/2008
Last Update Date	:	08/26/2008

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