Organization
TIMBERLAND MEDICINE CHEST 136 LLC
Active
Other names
TIMBERLAND MC PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
CHAD MICHEL (CEO)
(903) 885-0821
Entity
Organization
Contact information
Practice address
800 S TIMBERLAND DR, LUFKIN, TX 75901-4879
(936) 632-2260
(903) 885-1024
Mailing address
PO BOX 6397, TYLER, TX 75711-6397
(903) 885-0821
(903) 885-1024
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
28849
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1468952
—
TX
01
—
2142547
PK
—
Enumeration date
08/18/2006
Last updated
09/17/2015
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