Organization
THE PHARMACY SHOP, INC.
Active
Other names
The Pharmacy Shop II
Organization subpart
No
Provider details
NPI number
Authorized official
JUDI HENNEKE R. PH. (OWNER)
(979) 776-6800
Entity
Organization
Contact information
Practice address
1602 ROCK PRAIRIE RD, SUITE 1000, COLLEGE STATION, TX 77845-8306
(979) 764-4100
Mailing address
1602 ROCK PRAIRIE RD, SUITE 1000, COLLEGE STATION, TX 77845-8306
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
24235
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
145596
—
TX
Enumeration date
11/18/2005
Last updated
08/22/2020
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