Organization
PHARM NACOGDOCHES ACQUISITION LLC
Active
Other names
The Medicine Shoppe
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW FINN (OFFICER)
(817) 442-0484
Entity
Organization
Contact information
Practice address
212 NORTH ST, STE B, NACOGDOCHES, TX 75961
(817) 442-0484
(817) 977-5086
Mailing address
212 NORTH ST, STE B, NACOGDOCHES, TX 75961
(936) 569-6430
(817) 977-5086
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
12958
TX
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1275719
—
LA
05
—
143380
—
TX
01
—
4577613
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
01/23/2007
Last updated
03/07/2023
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