Organization
LARENDA INC
Active
Other names
Prescription Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY MADISON MOZINGO RPH (PRESIDENT , PHARMACIST IN CHARGE)
(903) 683-5436
Entity
Organization
Contact information
Practice address
156 W 5TH ST, RUSK, TX 75785-1218
(903) 683-5436
(903) 683-2689
Mailing address
156 W 5TH ST, RUSK, TX 75785-1218
(903) 683-5436
(903) 683-2689
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
14417
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
143691
—
TX
Enumeration date
11/08/2006
Last updated
06/01/2009
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