Organization
EPOCH PHARMACY SOLUTIONS SANTE FE MEDICINE MAN PHARMACY
Active
Other names
Medicine Man Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
BRUCE ROGERS (OWNER/MANAGER)
(361) 894-6430
Entity
Organization
Contact information
Practice address
13250 HIGHWAY 6, SANTA FE, TX 77510-7682
(409) 927-1979
(409) 925-7170
Mailing address
PO BOX 3670, VICTORIA, TX 77903-3670
(361) 894-6430
(361) 894-6431
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
26474
TX
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
146015
—
TX
01
—
2120311
PK
—
Enumeration date
05/27/2009
Last updated
02/15/2016
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