Organization
UHS RETAIL PHARMACY LLC
Active
Other names
CentRx Pharmacy at Northwest Texas
Organization subpart
No
Provider details
NPI number
Authorized official
MARVIN PEMBER MS (CEO)
(610) 302-3300
Entity
Organization
Contact information
Practice address
1501 S COULTER ST STE A, AMARILLO, TX 79106-1770
(806) 553-2455
(806) 356-7425
Mailing address
1501 S COULTER ST STE A, AMARILLO, TX 79106-1770
(806) 553-2455
(806) 356-7425
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
31092
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149558
—
TX
01
—
2166265
PK
—
Enumeration date
12/01/2016
Last updated
07/19/2018
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