Bastrop Medicine Shop LLC

NPI #1952071334 in Bastrop, Texas

Provider Information

NPI Number
1952071334
Entity Type
Organization
Organization Name
Bastrop Medicine Shop LLC
Primary Specialty
Pharmacy - Community/Retail Pharmacy
Enumeration Date
Sep 16, 2021
Last Updated
Sep 16, 2021

Practice Location

Address
1110 MAIN ST STE A
State
Texas
ZIP Code
78602-3219
Phone
(512) 350-4836

Authorized Official

Name
DR. OMAR ALEJANDRO FUENTES CURIEL, PHARMD
Title
PHARMACIST/PIC
Phone
(512) 350-4836

Specialties & Taxonomy Codes

Specialty
Pharmacy - Community/Retail PharmacyCommunity/Retail Pharmacy

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