Organization
MILITARY APOTHECARY LP
Active
Other names
ReNue Pharmacy, NetCare Pharmacy #2, ReNue RX #5, Vital Life Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAJ MILAN CHHADUA PHARMD (OWNER/MANAGING PARTNER)
(214) 422-2598
Entity
Organization
Contact information
Practice address
418 N LOOP 1604 W STE 104, SAN ANTONIO, TX 78232-1456
(210) 802-0553
Mailing address
PO BOX 2735, FRISCO, TX 75034-0051
(469) 294-2001
(469) 888-8448
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
—
—
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
24371
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
145643
—
TX
01
—
32470
TEXAS STATE BOARD OF PHARMACY
TX
01
—
4540399
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
07/30/2006
Last updated
08/14/2023
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