Organization
GROESBECK CITY DRUG
Active
Other names
Groesbeck City Drug
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASON GLEN THOMAS GRAVES PHARM. D (OWNER)
(254) 729-3092
Entity
Organization
Contact information
Practice address
404 S DR J B RIGGS DR, GROESBECK, TX 76642-1824
(254) 729-3092
(254) 729-3999
Mailing address
404 S DR J B RIGGS DR, GROESBECK, TX 76642-1824
(254) 729-3092
(254) 729-3999
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
28532
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2139869
PK
—
Enumeration date
08/18/2006
Last updated
11/21/2016
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