Organization
Q3BL PHARMACY LLC
Active
Organization
Q3BL PHARMACY LLC
Active
Other names
PAT WOOD DRUG STORE
Organization subpart
No
Provider details
NPI number
Authorized official
QUYNH PHAM (OWNER AND MANAGER)
(409) 985-8874
Entity
Organization
Contact information
Practice address
3648 GULFWAY DR, PORT ARTHUR, TX 77642-3674
(409) 985-8874
(409) 985-6568
Mailing address
PO BOX 3835, PORT ARTHUR, TX 77643-3835
(409) 985-8874
(409) 985-6568
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
23989
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
066691902
—
TX
05
—
066691903
—
TX
05
—
145523
—
TX
01
—
2090996
PK
—
Enumeration date
08/18/2006
Last updated
06/23/2016
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