Organization
PALACE PHARMACY LLC
Active
Other names
Medicine Box Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
SPENCER MALKIN (CORPORATE MEMBER)
(561) 404-8885
Entity
Organization
Contact information
Practice address
5200 COLLEYVILLE BLVD STE C, COLLEYVILLE, TX 76034-5828
(817) 599-7988
(800) 419-2801
Mailing address
5200 COLLEYVILLE BLVD STE C, COLLEYVILLE, TX 76034-5828
(817) 599-7988
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
28183
TX
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2136637
PK
—
Enumeration date
08/17/2012
Last updated
12/03/2015
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