Organization
ROCKWALL PHARMACY LLC
Active
Other names
Rockwall Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
TOMMY JONES (MANAGER)
(469) 769-1160
Entity
Organization
Contact information
Practice address
2504 RIDGE RD, SUITE 106, ROCKWALL, TX 75087-2569
(469) 769-1160
(469) 769-1161
Mailing address
2504 RIDGE RD, SUITE 106, ROCKWALL, TX 75087-2569
(469) 769-1160
(469) 769-1161
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
30777
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149386
—
TX
01
—
2159682
PK
—
Enumeration date
04/15/2016
Last updated
07/19/2018
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