Organization
62 ROSES WELLNESS, LLC
Active
Other names
24 Wellness Rx
Organization subpart
No
Provider details
NPI number
Authorized official
GARY BAXTER (CEO)
(903) 530-5987
Entity
Organization
Contact information
Practice address
3320 TROUP HWY STE 140, TYLER, TX 75701-8358
(682) 207-1232
(817) 900-0649
Mailing address
1620 W NORTHWEST HWY STE 100, GRAPEVINE, TX 76051-3219
(817) 572-0009
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33114
TEXAS STATE BOARD OF PHARMACY
TX
Enumeration date
06/09/2020
Last updated
06/09/2020
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