# VILLAGE LANE APOTHECARY, L.L.C.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Village Lane Apothecary
- **Organization subpart:** No

## Provider details

- **NPI number:** 1528431418
- **Authorized official:** LESLI HOLT (PHARMACIST IN CHARGE)
- **Authorized official phone:** (817) 717-2000

## Contact information

- **Practice address:** 60 VILLAGE LN STE 130, COLLEYVILLE, TX 76034-2928
- **Practice address phone:** (817) 717-2000
- **Practice address fax:** (817) 717-8424
- **Mailing address:** 60 VILLAGE LN STE 130, COLLEYVILLE, TX 76034-2928
- **Mailing address phone:** (817) 717-2000
- **Mailing address fax:** (817) 717-8424

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | — |
| 3336C0004X | Compounding Pharmacy | 30288 | TX | Yes |

## Other

- **Enumeration date:** 11/02/2015
- **Last updated:** 11/02/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2154971 | PK | — |