Organization
CITY SPECIALTY PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DEEPTHI GUJARATHI (OWNER)
(205) 253-9908
Entity
Organization
Contact information
Practice address
204 WJ BOAZ RD STE 300, SAGINAW, TX 76179-4396
(682) 593-9595
(682) 593-9594
Mailing address
204 WJ BOAZ RD STE 300, SAGINAW, TX 76179-4396
(682) 593-9595
(682) 593-9594
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
31547
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31547
TEXAS STATE BOARD OF PHARMACY
TX
Enumeration date
08/08/2017
Last updated
07/21/2022
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