Organization
RALLS PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JERRY DALE MCCUAN RPH (PHARMACIST)
(806) 253-2256
Entity
Organization
Contact information
Practice address
821 MAIN ST, RALLS, TX 79357
(806) 253-2256
(806) 253-2401
Mailing address
BOX 759, 821 MAIN ST, RALLS, TX 79357
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
01213
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
140384
—
TX
Enumeration date
05/22/2008
Last updated
05/22/2008
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