MEDICARE: PEOPLES 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	05334	TX

General Provider Information

NPI Number	:	1750509709
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PEOPLES PHARMACY

Provider Business Mailing Address
First Line	:	4018 NORTH LAMAR BLVD
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78756
Country	:	US
Telephone Number	:	512-459-9090
Fax Number	:	512-371-1246

Provider Business Practice Location Address
First Line	:	4018 N LAMAR BLVD
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78756-3714
Country	:	US
Telephone Number	:	512-459-9090
Fax Number	:	512-371-1246

Authorized Official
Title or Position	:	ACCOUNTS RECEIVABLE
Name	:	DONNA NICOLOFF
Credential	:
Telephone Number	:	512-447-1799

Provider Enumeration Date	:	04/23/2007
Last Update Date	:	09/14/2016

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Directions to “PEOPLES PHARMACY ” Practice Location

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