Organization
JERRY L PHILMON
Active
Other names
ALFORDS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ORVILLE ODOM (PARTNER)
(409) 736-2277
Entity
Organization
Contact information
Practice address
5897 W PORT ARTHUR RD, PORT ARTHUR, TX 77640-1754
(409) 736-2277
(409) 736-2854
Mailing address
PO BOX 5428, PORT ARTHUR, TX 77640-0428
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
00859
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
140074
—
TX
01
—
4537936
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/18/2006
Last updated
01/14/2010
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