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Organization

PHARMBLUE TEXAS LLC

Active
Other names
PharmBlue Texas LLC
Organization subpart
No

Provider details

NPI number
Authorized official
MICHAEL NELSON (OWNER,CEO, AO)
(724) 779-4720
Entity
Organization

Contact information

Practice address
1495 N 7TH ST, BEAUMONT, TX 77702-1345
(800) 967-5020
(844) 873-8760
Mailing address
P. O. BOX677949, DALLAS, TX 75267-7949
(724) 779-4720
(724) 779-4721

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
31190
TX
3336L0003X
Long Term Care Pharmacy
3336S0011X
Specialty Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1154799336
TX
01
2160901
PK
Enumeration date
09/04/2015
Last updated
03/23/2017
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