Organization
STAGECOACH PHARMACY
Active
Other names
Stagecoach Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
RICHARD CARRACEDO (OWNER)
(512) 401-7874
Entity
Organization
Contact information
Practice address
587 MAIN ST, BUDA, TX 78610-9257
(512) 746-1888
(512) 717-5558
Mailing address
1300 DACY LN STE 225, KYLE, TX 78640-4196
(512) 746-1888
(512) 504-9976
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
31007
TX
3336C0004X
Compounding Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2164162
PK
—
Enumeration date
09/09/2016
Last updated
02/04/2025
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