Organization
CITY DRUG STORE OF NOCONA INC
Active
Other names
Gibbs Drug Store
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RUSSELL WAYNE FENOGLIO RPH (PRESIDENT)
(940) 825-3226
Entity
Organization
Contact information
Practice address
216 CLAY STREET, NOCONA, TX 76255-0458
(940) 825-3226
(940) 825-4899
Mailing address
PO BOX 458, 216 CLAY STREET, NOCONA, TX 76255-0458
(940) 825-3226
(940) 825-4899
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
02607
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120815
—
TX
Enumeration date
03/05/2007
Last updated
08/22/2020
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