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Organization
LONG TERM CARE RX
Active
Organization
LONG TERM CARE RX
Active
Other names
LTC RX
Organization subpart
No
Provider details
NPI number
Authorized official
W DAVID SPENCE (PRESIDENT)
(979) 849-3001
Entity
Organization
Contact information
Practice address
2301 E MULBERRY ST STE B, ANGLETON, TX 77515-3804
(979) 849-3001
(979) 848-0900
Mailing address
2301 E MULBERRY ST, SUITE B, ANGLETON, TX 77515-3804
(979) 849-3001
(979) 848-0900
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
—
NULL
3336L0003X
Long Term Care Pharmacy
Primary
24288
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4539803
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
07/25/2006
Last updated
12/11/2009
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