Organization
LYNNS LA VEGA PHARMACY INC
Active
Organization
LYNNS LA VEGA PHARMACY INC
Active
Other names
LYNN'S LA VEGA PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
BRADY EVERETT RPH (PRESIDENT)
(254) 799-4949
Entity
Organization
Contact information
Practice address
2401 E WACO DR, WACO, TX 76705-3259
(254) 799-4949
(254) 867-0243
Mailing address
2401 E WACO DR, WACO, TX 76705-3259
(254) 799-4949
(254) 867-0243
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
5254
TX
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
141863
—
TX
01
—
2096115
PK
—
Enumeration date
08/18/2006
Last updated
03/23/2016
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