Organization
BRACKETTVILLE PHARMACY, LLC
Active
Organization
BRACKETTVILLE PHARMACY, LLC
Active
Other names
Main Drug Company
Organization subpart
No
Provider details
NPI number
Authorized official
YANKTON S WYATT (OWNER)
(830) 563-9334
Entity
Organization
Contact information
Practice address
201 N NIXON AVE, NIXON, TX 78140-2723
(830) 582-1851
(830) 582-1357
Mailing address
813 HOSPITAL DR, ANDREWS, TX 79714-3618
(432) 523-4861
(432) 524-4418
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149239
—
TX
01
—
2098543
PK
—
Enumeration date
12/26/2006
Last updated
08/19/2021
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