Organization
MEDICINE SHOPPE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHARON MOORE RPH (PHARMACIST OWNER)
(512) 454-2653
Entity
Organization
Contact information
Practice address
1508 W 35TH ST, AUSTIN, TX 78703-1437
(512) 454-2653
(512) 454-1035
Mailing address
1508 W 35TH ST, AUSTIN, TX 78703-1437
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
17520
TX
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
144593
—
TX
01
—
4579908
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
02/27/2007
Last updated
03/07/2023
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