Organization
MIDLAND PHARMACY , LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SRINIVASA TALLA (MANAGING MEMBER)
(845) 392-8254
Entity
Organization
Contact information
Practice address
3510 N. MIDKIFF RD, STE 100, MIDLAND, TX 79705-4834
(432) 697-7500
Mailing address
3510 N. MIDKIFF RD, STE 100, MIDLAND, TX 79705-4834
(432) 697-7500
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336C0004X
Compounding Pharmacy
—
—
Other
Enumeration date
09/16/2014
Last updated
08/24/2021
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