# CITY SPECIALTY PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205351574
- **Authorized official:** DEEPTHI GUJARATHI (OWNER)
- **Authorized official phone:** (205) 253-9908

## Contact information

- **Practice address:** 204 WJ BOAZ RD STE 300, SAGINAW, TX 76179-4396
- **Practice address phone:** (682) 593-9595
- **Practice address fax:** (682) 593-9594
- **Mailing address:** 204 WJ BOAZ RD STE 300, SAGINAW, TX 76179-4396
- **Mailing address phone:** (682) 593-9595
- **Mailing address fax:** (682) 593-9594

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | 31547 | TX | Yes |

## Other

- **Enumeration date:** 08/08/2017
- **Last updated:** 07/21/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 31547 | TEXAS STATE BOARD OF PHARMACY | TX |