Organization
GRAPEVINE DRUG MART INC
Active
Organization
GRAPEVINE DRUG MART INC
Active
Other names
GRAPEVINE DRUG MART INC
Organization subpart
No
Provider details
NPI number
Authorized official
STACY DANNELS RPH (PIC)
(817) 481-5780
Entity
Organization
Contact information
Practice address
1115 W NORTHWEST HWY STE H, GRAPEVINE, TX 76051-5010
(817) 481-5780
(817) 442-0435
Mailing address
1115 W NORTHWEST HWY STE H, GRAPEVINE, TX 76051-5010
(817) 481-5780
(817) 442-0435
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
16060
TX
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2103886
PK
—
Enumeration date
06/11/2006
Last updated
04/06/2016
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