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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