Organization
FREDERICKSBURG LTC
Active
Other names
Fredericksburg LTC
Organization subpart
No
Provider details
NPI number
Authorized official
WHITNEY ROBERTS (OWNER)
(830) 997-5800
Entity
Organization
Contact information
Practice address
707 N LLANO ST, SUITE B, FREDERICKSBURG, TX 78624-3943
(830) 997-5800
(830) 997-0068
Mailing address
707 N LLANO ST, SUITE B, FREDERICKSBURG, TX 78624-3943
(830) 997-5800
(830) 997-0068
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
26428
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2120084
PK
—
05
—
350224
—
TX
Enumeration date
05/01/2009
Last updated
03/01/2017
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