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Organization

JAMES LYNN WHITE

Active
Other names
Diamond Pharmacy No. 1
Organization subpart
No

Provider details

NPI number
Authorized official
MS. CATHY BOHANNON RPH (PHARMACIST IN CHARGE)
(940) 325-2541
Entity
Organization

Contact information

Practice address
100 SE 17TH AVE, MINERAL WELLS, TX 76067-5607
(940) 325-2541
Mailing address
PO BOX 1313, MINERAL WELLS, TX 76068-1313
(940) 325-2541

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
12245
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
143071
TX
Enumeration date
01/14/2007
Last updated
08/12/2008
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