Organization
ABELDT ENTERPRISES INC
Active
Other names
BRICKSTREET PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY V ABELDT RPH (PRESIDENT/OWNER)
(903) 533-8155
Entity
Organization
Contact information
Practice address
314 W RUSK ST, TYLER, TX 75701-1513
(903) 533-8155
(903) 533-8158
Mailing address
314 W RUSK ST, TYLER, TX 75701-1513
(903) 533-8155
(903) 533-8158
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
006419
TX
3336C0003X
Community/Retail Pharmacy
21015
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
145088
—
TX
05
—
1455244801
—
TX
01
—
530989
BCBSTX
TX
Enumeration date
02/22/2007
Last updated
06/12/2024
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