Organization
LY'S PHARMACY INC
Active
Organization
LY'S PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TAM T LY PHARMACIST (PRESIDENT)
(956) 544-2059
Entity
Organization
Contact information
Practice address
3675 BOCA CHICA BLVD, STE D, BROWNSVILLE, TX 78521-4483
(956) 544-2059
Mailing address
1410 FM 802, BROWNSVILLE, TX 78521-2771
(956) 544-2059
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
24980
TX
3336C0003X
Community/Retail Pharmacy
Primary
24980
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
144996
—
TX
Enumeration date
02/02/2007
Last updated
07/14/2008
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