Organization
TIM WASSON INCORPORATED
Active
Other names
MEDICINE SHOPPE
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TERRY TIM WASSON RPH (PRESIDENT)
(903) 657-1593
Entity
Organization
Contact information
Practice address
612 E MAIN ST, HENDERSON, TX 75652-2617
(903) 657-1593
(903) 657-8448
Mailing address
612 E MAIN ST, HENDERSON, TX 75652-2617
(903) 657-1593
(903) 657-8448
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
21419
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
143452
—
TX
01
—
4567737
NCPDP #
TX
Enumeration date
07/31/2005
Last updated
03/07/2023
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