Organization
GEORGE C SIMMONS JR
Active
Other names
GORMAN PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE SIMMONS RPH (OWNER / PIC)
(254) 734-2859
Entity
Organization
Contact information
Practice address
117 S KENT ST, GORMAN, TX 76454-3060
(254) 734-2859
(254) 734-2859
Mailing address
PO BOX 608, GORMAN, TX 76454-0608
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
05566
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
141946
—
TX
01
—
4521197
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/18/2006
Last updated
01/06/2010
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