Archie Pharmacy LLC
Organization Active NPI Community/Retail Pharmacy · Vidor, TX
NPI 1275912453 · NPPES record last updated Sep 9, 2021
Key facts
- NPI
- 1275912453
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- 29936 (TX)
- Legal business name
- ARCHIE PHARMACY LLC
- Practice address
- 305 S Archie St
Vidor, TX 77662-4840 - Phone
- (409) 242-3124
- Fax
- (888) 870-3156
- NPI assigned
- May 21, 2015
- Organization subpart
- No
Authorized official
- Name
- Trey Haney
- Title
- Operations Manager
- Phone
- (409) 769-2406
National Provider Directory
Locations
305 S Archie St
Vidor, TX 77662
Phone (409) 242-3124
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 29936 | TX | Yes |
| Compounding Pharmacy | 3336C0004X | |||
| Long Term Care Pharmacy | 3336L0003X | |||
| Specialty Pharmacy | 3336S0011X |
Addresses
Primary practice location
305 S Archie St
Vidor, TX 77662-4840
Mailing address
305 S Archie St
Vidor, TX 77662-4840
Phone (409) 242-3124
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2152055 | Other | PK |
Other names
- FP Specialty Pharmacy
Other providers in Vidor, TX
- American Eagle Medical Supply
- Wendi Ellen Ames
- Charlene Ashworth
- Christyna Badeaux
- Karine A Bah
- Jessica Miller Baker
- Shannon Baldwin
All providers in Vidor, TX · Community/Retail Pharmacy in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 9, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.