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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