Organization
EASTTEXRX LLC
Active
Other names
Walker Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
EDDIE GOODE (V.P. EASTTEXRX, LLC)
(903) 845-2573
Entity
Organization
Contact information
Practice address
402B W UPSHUR, GLADEWATER, TX 75647
(903) 845-2573
(903) 845-2266
Mailing address
402B W UPSHUR, GLADEWATER, TX 75647
(903) 845-2573
(903) 845-2266
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
27066
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5902095
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
12/21/2010
Last updated
12/21/2010
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