Organization
MINYARD FOOD STORES INC
Active
Organization
MINYARD FOOD STORES INC
Active
Other names
CARNIVAL PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
RONALD PETERS (VP PHARMACY)
(972) 393-8329
Entity
Organization
Contact information
Practice address
3320 AVENUE K, PLANO, TX 75074-2306
(972) 578-1009
(972) 578-4894
Mailing address
3320 AVENUE K, PLANO, TX 75074-2306
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
25720
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4545894
OTHER ID NUMBER
—
Enumeration date
09/25/2007
Last updated
03/14/2008
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