Organization
LEGACY PHARM VENTURES LLC
Active
Other names
Jacobs Family Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
TIM JACOBS (PHARMACIST/OWNER)
(325) 647-7093
Entity
Organization
Contact information
Practice address
2701 AUSTIN AVE, BROWNWOOD, TX 76801-5834
(325) 646-2322
(325) 646-2322
Mailing address
2701 AUSTIN AVE, BROWNWOOD, TX 76801-5834
(325) 646-1100
(325) 646-1104
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28554
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2138803
PK
—
Enumeration date
05/16/2013
Last updated
01/06/2014
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