Organization
WEST OLD CORNER DRUG, INC
Active
Other names
OLD CORNER DRUG
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RANDY JAMES NIEMEYER PHARMD (OWNER/PHARMACIST)
(254) 826-5122
Entity
Organization
Contact information
Practice address
200 N MAIN ST, WEST, TX 76691-1207
(254) 826-5122
(254) 826-3768
Mailing address
200 N MAIN ST, WEST, TX 76691-1207
(254) 826-5122
(254) 826-3768
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
6826
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
142315
—
TX
Enumeration date
09/13/2017
Last updated
07/21/2022
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