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Organization
TEXAS BLUEBONNET PHARMACY
Active
Organization
TEXAS BLUEBONNET PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GEORGE FETTINGER CPA (CEO)
(817) 275-1040
Entity
Organization
Contact information
Practice address
808 UTILITY RD, SANGER, TX 76266-9131
(940) 458-3184
(940) 458-9175
Mailing address
808 UTILITY RD, SANGER, TX 76266-9131
(940) 458-3184
(940) 458-9175
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0899813574
SURESCRIPTS
—
05
—
145822
—
TX
01
—
25470
TXSTATE BOARD OF PHARMACY
TX
01
—
4544513
NCPDP
TX
Enumeration date
12/19/2006
Last updated
03/07/2023
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