Organization
EDNA PHARMACY LLC
Active
Other names
Edna Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. IKE IKE DR (MANAGER)
(361) 308-5039
Entity
Organization
Contact information
Practice address
604 N WELLS ST, EDNA, TX 77957-2719
(361) 308-5039
Mailing address
604 N WELLS ST, EDNA, TX 77957-2719
(361) 308-5039
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
150002
—
TX
Enumeration date
02/06/2019
Last updated
11/21/2025
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