Organization
LMR WESTER ST PHARMACY
Active
Other names
Medical Center Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JILANI ASIM (OFFICER)
(936) 632-3833
Entity
Organization
Contact information
Practice address
511 GASLIGHT BLVD, LUFKIN, TX 75904-3127
(936) 632-3833
(936) 632-2832
Mailing address
511 GASLIGHT BLVD, LUFKIN, TX 75904-3127
(936) 632-3833
(936) 632-2832
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
29522
TX
3336C0004X
Compounding Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2148596
PK
—
Enumeration date
11/06/2014
Last updated
11/06/2014
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