Organization
DECATUR HOSPITAL AUTHORITY
Active
Other names
Wise Health System Community Care Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JASON WREN (CEO)
(940) 627-5921
Entity
Organization
Contact information
Practice address
609 MEDICAL CENTER DRIVE, SUITE 1100, DECATUR, TX 76234
(940) 626-2555
(940) 263-3150
Mailing address
609 MEDICAL CENTER DR STE 1100, DECATUR, TX 76234-3840
(940) 626-2555
(940) 263-3150
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
TX
Enumeration date
05/27/2021
Last updated
09/07/2021
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