Organization
JIM BOB EVERETT
Active
Other names
EVERETTS PHARMACY SONORA
Organization subpart
No
Provider details
NPI number
Authorized official
JIM BOB EVERETT REG. PHARMACIST (OWNER/PIC)
(325) 387-2541
Entity
Organization
Contact information
Practice address
417 HIGHWAY 277 N, SONORA, TX 76950-2204
(325) 387-2541
(325) 387-5423
Mailing address
PO BOX 527, SONORA, TX 76950-0527
(325) 387-2541
(325) 387-5423
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
23182
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
145400
—
TX
01
—
23182
TEXAS STATE BOARD OF PHAR
TX
01
—
B0134686
DPS NUMBER
TX
Enumeration date
08/28/2006
Last updated
03/07/2023
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