Organization
TARRYTOWN EXPOCARE, LLC
Active
Other names
Tarrytown Expocare Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ELIJAH ERICKSON (DIRECTOR OF REVENUE CYCLE)
(512) 828-3253
Entity
Organization
Contact information
Practice address
8500 SHOAL CREEK BLVD BLDG 1, AUSTIN, TX 78757-6888
(512) 617-7312
(512) 617-7313
Mailing address
8500 SHOAL CREEK BLVD BLDG 1, AUSTIN, TX 78757-6888
(512) 617-7312
(512) 617-7313
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
28150
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
146679
—
TX
01
—
2137179
PK
—
05
—
351075
—
TX
Enumeration date
07/30/2012
Last updated
08/12/2024
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