Organization
MINYARD FOOD STORES INC.
Active
Other names
Carnival Pharmacy #209
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL D. BYARS (PRESIDENT/CEO)
(972) 393-8700
Entity
Organization
Contact information
Practice address
2204 AIRPORT FWY, BEDFORD, TX 76022-6061
(817) 354-9389
(817) 571-4681
Mailing address
2204 AIRPORT FWY, BEDFORD, TX 76022-6061
(817) 354-9389
(817) 571-4681
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
15453
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4588844
NABP ID #
TX
05
—
463530
—
TX
Enumeration date
11/01/2006
Last updated
11/16/2007
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