Organization
W5 PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CODY DEAN WIMBERLEY PHARMD (OWNER/PIC)
(254) 366-8291
Entity
Organization
Contact information
Practice address
1110 E WALKER ST, BRECKENRIDGE, TX 76424-3824
(254) 366-8291
Mailing address
804 WESTRIDGE CIR, BRECKENRIDGE, TX 76424-2532
(254) 366-8291
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336C0004X
Compounding Pharmacy
—
—
Other
Enumeration date
02/24/2021
Last updated
04/19/2022
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