Organization
DISMUKESRX LLC
Active
Other names
Dismukes Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
CATHY ALLEN (MANAGING MEMBER)
(325) 625-9448
Entity
Organization
Contact information
Practice address
511 E DAVIS ST, LULING, TX 78648-2317
(830) 875-2811
(830) 875-2283
Mailing address
PO BOX 1011, COLEMAN, TX 76834-1011
(325) 214-2087
(325) 625-9447
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
31530
TX
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149719
—
TX
01
—
2171850
PK
—
01
—
31530
TSBP
TX
01
—
5922744
NCPDP
TX
Enumeration date
08/30/2017
Last updated
11/03/2020
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