Organization
CB HOLLOW, LLC
Active
Other names
Good Life Pharmacy #2
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RIYAD A HASANALI PHARM.D. (MANAGING MEMBER)
(210) 819-4515
Entity
Organization
Contact information
Practice address
13331 NACOGDOCHES RD, SAN ANTONIO, TX 78217
(210) 819-4515
(210) 819-4516
Mailing address
26108 OVERLOOK PKWY BLDG 4, SAN ANTONIO, TX 78260-6046
(210) 819-4515
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
31706
TX
Other
Enumeration date
12/12/2017
Last updated
12/12/2017
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