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Organization
WEST OLD CORNER DRUG, INC
Active
Organization
WEST OLD CORNER DRUG, INC
Active
Other names
OLD CORNER DRUG
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDY JAMES NIEMEYER PHARMD (PHARMACIST/PRESIDENT)
(254) 826-5122
Entity
Organization
Contact information
Practice address
200 N MAIN ST, WEST, TX 76691-1207
(254) 826-5122
(254) 826-3768
Mailing address
200 N MAIN ST, WEST, TX 76691-1207
(254) 826-5122
(254) 826-3768
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
142315
—
TX
05
—
16437801
—
TX
Enumeration date
10/26/2006
Last updated
03/06/2021
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