Organization
BRUCE'S MARKET BASKET, LTD.
Active
Other names
Bruce's Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID SKYLAR THOMPSON (PRESIDENT)
(409) 727-3104
Entity
Organization
Contact information
Practice address
6001 39TH ST, GROVES, TX 77619-4651
(409) 749-6405
(409) 749-6505
Mailing address
PO BOX 1717, NEDERLAND, TX 77627-1717
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
20885
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
143495
—
TX
Enumeration date
05/17/2006
Last updated
02/04/2011
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