Organization
TARRYTOWN PHARMACY LLC
Active
Other names
TARRYTOWN PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MARK NEWBERRY (PRESIDENT)
(512) 478-6419
Entity
Organization
Contact information
Practice address
2727 EXPOSITION BLVD, STE 105, AUSTIN, TX 78703-1228
(512) 478-6419
(512) 478-1638
Mailing address
2727 EXPOSITION BLVD, STE 105, AUSTIN, TX 78703-1228
(512) 478-6419
(512) 478-1638
Taxonomy
Speciality
Code
Description
License number
State
163WD0400X
Diabetes Educator Registered Nurse
—
—
183500000X
Pharmacist
—
—
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
—
—
261QP2300X
Primary Care Clinic/Center
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
1812
TX
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110162
—
TX
01
—
2093490
PK
—
Enumeration date
10/25/2006
Last updated
08/31/2022
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