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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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