Organization
R & R STARR AMIGOS LLC
Active
Other names
Popular Pharmacy # 3
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANIL GOTTIMUKKALA (PHARMACIST IN CHARGE)
(973) 885-0060
Entity
Organization
Contact information
Practice address
2849 E GRANT ST, ROMA, TX 78584-8914
(973) 885-0060
Mailing address
3406 PLANTATION GROVE BLVD, MISSION, TX 78572-2847
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
34593
TEXAS PHARMACY LICENSE
TX
Enumeration date
01/30/2023
Last updated
01/30/2023
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