Organization
BRISTOL PHARMACY LLC
Active
Other names
Bristol Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
CUONG TRAN (PRESIDENT)
(469) 771-4117
Entity
Organization
Contact information
Practice address
4001 LONG PRAIRIE RD STE 100, FLOWER MOUND, TX 75028-1528
(469) 771-4117
(469) 771-4118
Mailing address
4001 LONG PRAIRIE RD STE 100, FLOWER MOUND, TX 75028-1528
(469) 771-4117
(469) 771-4118
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
31494
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2173017
PK
—
Enumeration date
04/10/2017
Last updated
01/09/2019
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