Organization
BRACKETTVILLE PHARMACY, LLC
Active
Organization
BRACKETTVILLE PHARMACY, LLC
Active
Other names
Clinic Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
YANKTON WYATT PHARMD (PRESIDENT)
(432) 523-4861
Entity
Organization
Contact information
Practice address
201 JAMES ST., BRACKETTVILLE, TX 78832
(830) 563-9334
(830) 563-9065
Mailing address
813 HOSPITAL DRIVE, ANDREWS, TX 79714
(432) 523-4861
(432) 524-4918
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
150055
—
TX
Enumeration date
12/23/2005
Last updated
07/11/2023
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