Derek Madison Ethridge, RPH

NPI #1700478575 in Lytle, Texas

Provider Information

NPI Number: 1700478575
Entity Type: Individual
Name: Derek Madison Ethridge, RPH
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Pharmacist
Credential: RPH
Enumeration Date: Feb 3, 2021
Last Updated: Feb 3, 2021

Practice Location

Address: 19450 MCDONALD ST STE 102
City: Lytle
State: Texas
ZIP Code: 78052-3649
Phone: (830) 988-0100

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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