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Organization

CRESTVIEW PHARMACY LLC

Active
Other names
Crestview Pharmacy
Organization subpart
No

Provider details

NPI number
Authorized official
JERRY HARPER (MR)
(512) 452-9535
Entity
Organization

Contact information

Practice address
7100 WOODROW AVE, AUSTIN, TX 78757-1802
(512) 452-9535
(512) 452-9583
Mailing address
7100 WOODROW AVE, AUSTIN, TX 78757-1802
(512) 452-9535
(512) 452-9583

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
27870
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
5905508
NCPDP PROVIDER IDENTIFICATION NUMBER
Enumeration date
03/27/2012
Last updated
03/27/2012
About Stedi
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