# RED RIVER PHARMACY SERVICES

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

## Provider details

- **NPI number:** 1336225002
- **Authorized official:** MR. JASEN TATE CREEK R.PH. (PHARMACIST IN CHARGE)
- **Authorized official phone:** (903) 792-1721

## Contact information

- **Practice address:** 1327 COLLEGE DR, SUITE A, TEXARKANA, TX 75503-3531
- **Practice address phone:** (903) 792-1721
- **Practice address fax:** (903) 792-2241
- **Mailing address:** 1327 COLLEGE DR, SUITE A, TEXARKANA, TX 75503-3531
- **Mailing address phone:** (903) 792-1721
- **Mailing address fax:** (903) 792-2241

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | 23886 | TX | Yes |

## Other

- **Enumeration date:** 10/27/2006
- **Last updated:** 08/27/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 145562 | — | TX |