Organization
BEDFORD PHARMACY LLC
Active
Organization
BEDFORD PHARMACY LLC
Active
Other names
Bedford Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SUBBU PALANISAMY RPH (CORPORATE MANAGER)
(203) 500-6127
Entity
Organization
Contact information
Practice address
2816 CENTRAL DR STE 160, BEDFORD, TX 76021
(817) 786-8011
Mailing address
2816 CENTRAL DR STE 160, BEDFORD, TX 76021
(817) 786-8011
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
32365
TEXAS STATE BOARD OF PHARMACY
TX
Enumeration date
11/27/2018
Last updated
11/27/2018
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