Organization
SMILE RX PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DEVINDER SHAW (OWNER)
(845) 807-4157
Entity
Organization
Contact information
Practice address
490 IH 10 N STE 400, BEAUMONT, TX 77702-1819
(409) 554-8168
Mailing address
490 IH 10 N STE 400, BEAUMONT, TX 77702-1819
(409) 554-8168
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33536
TEXAS STATE BOARD PHARMACY LICENSE
TX
Enumeration date
12/07/2020
Last updated
12/07/2020
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