Organization
PBG INC
Active
Other names
BUDA DRUG STORE
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY GRAY RPH (OWNER)
(512) 913-3480
Entity
Organization
Contact information
Practice address
203 RAILROAD ST, BUILD 2 STE B, BUDA, TX 78610-3383
(512) 312-2111
(512) 295-8300
Mailing address
203 RAILROAD ST, BUILD 2 STE B, BUDA, TX 78610-3383
(512) 312-2111
(512) 295-8300
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
24956
TX
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
145666
—
TX
01
—
4540666
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
06/19/2006
Last updated
03/22/2022
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