Organization
LMR WESTER ST PHARMACY
Active
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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