Organization
ALTIMATE CARE PHARMACY LLC
Active
Other names
Altimate Care Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
KYLE RICHARDSON (OWNER)
(940) 390-7103
Entity
Organization
Contact information
Practice address
2813 N COMMERCE ST STE 115, FORT WORTH, TX 76106-7245
(682) 385-9100
(682) 385-9102
Mailing address
2813 N COMMERCE ST STE 115, FORT WORTH, TX 76106-7245
(682) 385-9100
(682) 385-9102
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149538
—
TX
01
—
2164117
PK
—
Enumeration date
09/12/2016
Last updated
06/11/2020
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