Organization
UNIVERSITY OF TEXAS AT AUSTIN OFFICE OF ACCTG
Active
Other names
Forty Acres Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY WEAVER RPH (CHIEF PHARMACIST)
(512) 471-1824
Entity
Organization
Contact information
Practice address
100 F W DEAN KEETON SSB 1 110, AUSTIN, TX 78712-1108
(512) 471-1824
(512) 475-8218
Mailing address
100 W DEAN KEETON ST, STOP A3910, AUSTIN, TX 78712-1091
(512) 471-1824
(512) 475-8218
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
05620
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2093495
PK
—
Enumeration date
02/05/2007
Last updated
07/06/2016
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