Organization
LSCC GEORGETOWN PHARMACY- WILLIAMS DRIVE
Active
Other names
LSCC Georgetown Pharmacy- Williams Drive
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN DAVID CALVIN (CEO)
(877) 800-5722
Entity
Organization
Contact information
Practice address
2423 WILLIAMS DR, SUITE 109, GEORGETOWN, TX 78628-3200
(512) 686-0155
(512) 869-8482
Mailing address
2423 WILLIAMS DR STE 107, GEORGETOWN, TX 78628-3269
(877) 800-5722
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
26364
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2119479
PK
—
Enumeration date
03/20/2009
Last updated
04/30/2025
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