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Individual

CAROL M JOHNSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PHARMACIST

Contact information

Practice address
601 S BLISS AVE, DUMAS, TX 79029-4434
(806) 935-2333
Mailing address
601 S BLISS AVE, DUMAS, TX 79029-4434
(806) 935-2333

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
16435
TX
3336C0003X
Community/Retail Pharmacy
02472
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
02472
PHARMACY STORE NUMBER
TX
05
143922
TX
01
16435
PERSONAL PHARMACY LICENSE
TX
01
20002809
DPS
TX
Enumeration date
03/29/2007
Last updated
09/11/2025
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