Organization
TD HEALTHCARE LLC
Active
Other names
Denver City Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID FUNG RPH (OWNER/MANAGING OFFICER)
(813) 244-9882
Entity
Organization
Contact information
Practice address
105 E BROADWAY ST, DENVER CITY, TX 79323-3225
(806) 592-3333
(806) 592-3633
Mailing address
105 E BROADWAY ST, DENVER CITY, TX 79323-3225
(806) 592-3333
(806) 592-3633
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
27633
TX
3336C0004X
Compounding Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
148297
—
TX
01
—
2131862
PK
—
Enumeration date
09/07/2011
Last updated
08/03/2017
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