Organization
BASTROP MEDICINE SHOP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. OMAR ALEJANDRO FUENTES CURIEL PHARMD (PHARMACIST)
(512) 549-3222
Entity
Organization
Contact information
Practice address
1110 MAIN ST STE A, BASTROP, TX 78602-3219
(512) 549-3222
(512) 549-3777
Mailing address
1110 MAIN ST STE A, BASTROP, TX 78602-3219
(512) 549-3222
(512) 549-3777
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Enumeration date
04/18/2022
Last updated
04/18/2022
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