Organization
JACKSON COUNTY HOSPITAL DISTRICT
Active
Other names
JACKSON COUNTY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
RIC MARTI RPH. (PIC)
(361) 782-7822
Entity
Organization
Contact information
Practice address
1013 S WELLS ST, BLDG B, EDNA, TX 77957-4045
(361) 782-7822
Mailing address
1013 S WELLS ST, BLDG B, EDNA, TX 77957-4045
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
25042
TX
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
145673
—
TX
01
—
4541113
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
01/25/2007
Last updated
03/03/2010
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