Organization
PEACH PHARMACY, LLC
Active
Other names
Peach Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
IKEEYA HUNT (OWNER)
(682) 347-4022
Entity
Organization
Contact information
Practice address
2401 W PIONEER PKWY STE 117, PANTEGO, TX 76013-6038
(682) 347-4022
(682) 347-4021
Mailing address
2401 W PIONEER PKWY STE 117, PANTEGO, TX 76013-6038
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
32863
STATE PHAMARCY LICENSE
TX
05
—
691078
—
TX
Enumeration date
10/10/2019
Last updated
10/23/2020
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