Organization
GOOSE CREEK PHARMACY LLC
Active
Other names
Goose Creek Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY TERRY (PIC/SOLE OWNER/AO)
(281) 838-8640
Entity
Organization
Contact information
Practice address
2007 N MAIN ST, BAYTOWN, TX 77520-2746
(281) 838-8640
(281) 628-7970
Mailing address
2007 N MAIN ST, BAYTOWN, TX 77520-2746
(281) 838-8640
(281) 628-7970
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
30867
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149527
—
TX
01
—
2162475
PK
—
Enumeration date
08/12/2016
Last updated
07/19/2018
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