Organization
CENTER STREET PHARMACY INC.
Active
Other names
FANNIN PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MAUREEN REEDER RPH (OWNER)
(903) 583-8017
Entity
Organization
Contact information
Practice address
2108 N CENTER ST, BONHAM, TX 75418-2628
(903) 583-8017
(903) 583-4232
Mailing address
2108 N CENTER ST, BONHAM, TX 75418-2628
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
25288
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
141837
—
TX
01
—
4553827
OTHER ID NUMBER
—
Enumeration date
02/23/2007
Last updated
09/13/2007
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