Organization
GRAND AVE PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRIS ADLAKHA (PHARMACY MANAGER)
(512) 377-1999
Entity
Organization
Contact information
Practice address
1615 GRAND AVENUE PKWY, SUITE 104, PFLUGERVILLE, TX 78660-2059
(512) 377-1999
Mailing address
1615 GRAND AVENUE PKWY, SUITE 104, PFLUGERVILLE, TX 78660-2059
(512) 377-1999
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
55334
TX
3336C0004X
Compounding Pharmacy
55334
TX
Other
Enumeration date
08/08/2014
Last updated
08/08/2014
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