Organization
ARCHIE PHARMACY LLC
Active
Other names
FP Specialty Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
TREY HANEY (OPERATIONS MANAGER)
(409) 769-2406
Entity
Organization
Contact information
Practice address
305 S ARCHIE ST, VIDOR, TX 77662-4840
(409) 242-3124
(888) 870-3156
Mailing address
305 S ARCHIE ST, VIDOR, TX 77662-4840
(409) 242-3124
(888) 870-3156
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
29936
TX
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2152055
PK
—
Enumeration date
05/21/2015
Last updated
09/09/2021
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