Organization
KENNETH J FITZGERALD
Active
Organization
KENNETH J FITZGERALD
Active
Other names
BANGS DRUG MART
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH FITZGERALD RPH (PHARMACIST AND OWNER)
(325) 752-6241
Entity
Organization
Contact information
Practice address
104 E KYLE ST, BANGS, TX 76823-3146
(325) 752-7214
(325) 752-7134
Mailing address
PO BOX 459, BANGS, TX 76823-0459
(325) 752-7214
(325) 752-7134
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
01136
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
140909
—
TX
01
—
4542824
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
11/03/2006
Last updated
12/22/2010
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