Organization
BANDERA DRUG, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WAYNE ANTENEN R.PH. (MANAGER)
(830) 796-3111
Entity
Organization
Contact information
Practice address
1100 MULBERRY STREET, BANDERA, TX 78003
(830) 796-3111
(830) 796-3115
Mailing address
P.O. BOX 2280, 1100 MULBERRY STREET, BANDERA, TX 78003
(830) 796-3111
(830) 796-3115
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
30261
TX
Other
Enumeration date
10/23/2015
Last updated
10/23/2015
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