Organization
RED RIVER PHARMACY SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASEN TATE CREEK R.PH. (PHARMACIST IN CHARGE)
(903) 792-1721
Entity
Organization
Contact information
Practice address
1327 COLLEGE DR, SUITE A, TEXARKANA, TX 75503-3531
(903) 792-1721
(903) 792-2241
Mailing address
1327 COLLEGE DR, SUITE A, TEXARKANA, TX 75503-3531
(903) 792-1721
(903) 792-2241
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
23886
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
145562
—
TX
Enumeration date
10/27/2006
Last updated
08/27/2012
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