Organization
DURAMED
Active
Organization
DURAMED
Active
Other names
Corner Drug
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT TODD HUMPHRIES PHARMD (VICE PRESIDENT)
(325) 247-4155
Entity
Organization
Contact information
Practice address
600 BESSEMER AVE, LLANO, TX 78643-1608
(325) 247-4155
(325) 247-5554
Mailing address
600 BESSEMER AVE, LLANO, TX 78643-1608
(325) 247-4155
(325) 247-5554
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
4592235
TX
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
144929
—
TX
Enumeration date
08/14/2006
Last updated
10/30/2024
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