Organization
TEXAS INJURED WORKERS PHARMACY
Active
Other names
TEXAS INJURED WORKERS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
PAULETTE SALVANT (PIC)
(817) 861-4631
Entity
Organization
Contact information
Practice address
2204 PARK SPRINGS BLVD, STE B, ARLINGTON, TX 76013-5642
(817) 861-3784
(817) 861-4638
Mailing address
PO BOX 181013, ARLINGTON, TX 76096-1013
(817) 861-4635
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
3336S0011X
Specialty Pharmacy
Primary
20798
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2098059
PK
—
Enumeration date
12/01/2006
Last updated
12/20/2013
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