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Organization

SOUTHWEST HEMATOLOGY-ONCOLOGY ASSOCIATES PA

Active
Other names
SOUTHWEST HEMATOLOGY ONCOLOGY ASSOCIATES LLC
Organization subpart
No

Provider details

NPI number
Authorized official
BRANCE WILSON PHARMD (DIRECTOR OF PHARMACY)
(806) 793-6654
Entity
Organization

Contact information

Practice address
4002 21ST ST, STE B, LUBBOCK, TX 79410-1135
(806) 793-8310
(806) 793-7871
Mailing address
4002 21ST ST, STE B, LUBBOCK, TX 79410-1135
(806) 793-8310
(806) 793-7871

Taxonomy

Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
15666
TX
3336S0011X
Specialty Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0081556501
TX
01
2093517
PK
Enumeration date
08/10/2006
Last updated
07/28/2015
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