MEDICARE: TOWER MEDIC PHARMACY INC

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	3336L0003X	Long Term Care Pharmacy

General Provider Information

NPI Number	:	1942084447
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TOWER MEDIC PHARMACY INC

Provider Business Mailing Address
First Line	:	607 W MAGNOLIA AVE STE B
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76104-4608
Country	:	US
Telephone Number	:	817-336-8133
Fax Number	:

Provider Business Practice Location Address
First Line	:	607 W MAGNOLIA AVE STE B
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76104-4608
Country	:	US
Telephone Number	:	817-336-8133
Fax Number	:	817-314-7227

Authorized Official
Title or Position	:	MANAGER
Name	:	MELVIN BRUCE MUSGROVE
Credential	:	R.PH
Telephone Number	:	817-336-8133

Provider Enumeration Date	:	08/24/2023
Last Update Date	:	08/24/2023

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