Organization
FW MEDICAL SUPPLIES, LLC D/B/A DANDY DRUG
Active
Other names
Dandy Drug
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN KUPER (PIC/OWNER)
(817) 456-4348
Entity
Organization
Contact information
Practice address
5450 E FM 1187, BURLESON, TX 76028-3060
(817) 483-3784
(817) 483-0568
Mailing address
5450 E FM 1187, BURLESON, TX 76028-3060
(817) 483-3784
(817) 483-0568
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28891
TX
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2142996
PK
—
Enumeration date
11/19/2013
Last updated
11/19/2013
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