Shallowater Pharmacy, LLC
NPI #1396947024 in Shallowater, Texas
Provider Information
- NPI Number
- 1396947024
- Entity Type
- Organization
- Organization Name
- Shallowater Pharmacy, LLC
- Primary Specialty
- Pharmacy - Community/Retail Pharmacy
- Enumeration Date
- Jun 4, 2007
- Last Updated
- Mar 7, 2013
Practice Location
- Address
- 1502 12TH ST STE B
- City
- Shallowater
- State
- Texas
- ZIP Code
- 79363-5651
- Phone
- (806) 832-0250
Authorized Official
- Name
- MR. MICAH GLENN PRATT, PHARM D
- Title
- OWNER
- Phone
- (806) 385-4491
Specialties & Taxonomy Codes
| Specialty |
|---|
| Pharmacy - Community/Retail Pharmacy — Community/Retail Pharmacy |
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