Organization
DICK STORSETH INC
Active
Other names
VILLAGE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DICK STORSETH RPH (PRES AND PIC)
(806) 352-5624
Entity
Organization
Contact information
Practice address
2600 WOLFLIN VLG, AMARILLO, TX 79109-1838
(806) 352-5624
(806) 353-9270
Mailing address
2600 WOLFLIN VLG, AMARILLO, TX 79109-1838
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
Primary
04953
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
141828
—
TX
01
—
4546175
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
08/09/2005
Last updated
07/31/2007
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