Organization
HENRIETTA PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK MATHEWS (PHARMACIST)
(940) 538-4361
Entity
Organization
Contact information
Practice address
124 N BRIDGE ST, HENRIETTA, TX 76365-2804
(940) 538-4361
(940) 538-6345
Mailing address
124 N BRIDGE ST, HENRIETTA, TX 76365-2804
(940) 538-4361
(940) 538-6345
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
24672752243
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
068020902
—
TX
Enumeration date
01/11/2007
Last updated
12/17/2018
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