Organization
KELLY G PRATT
Active
Organization
KELLY G PRATT
Active
Other names
SOUTH PLAINS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY PRATT RPH (OWNER)
(806) 385-4491
Entity
Organization
Contact information
Practice address
1400 MAIN ST, AMHERST, TX 79312
(806) 246-3683
Mailing address
PO BOX 670, AMHERST, TX 79312-0670
(806) 246-3683
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
25112
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
145681
—
TX
01
—
4594809
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
08/10/2006
Last updated
02/14/2008
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