Three Rivers Pharmacy, LLC

Organization Active NPI Community/Retail Pharmacy · Three Rivers, TX

NPI 1821170002 · NPPES record last updated Mar 8, 2024

Key facts

NPI
1821170002
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
Legal business name
THREE RIVERS PHARMACY, LLC
Practice address
101 W. Thornton
Three Rivers, TX 78071
Phone
(361) 786-3757
Fax
(361) 786-3279
NPI assigned
Oct 19, 2006
Organization subpart
No

Authorized official

Name
Yankton Wyatt, PHARMD
Title
Vice President
Phone
(432) 523-4861

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Campbell Drug Store (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Yes

Addresses

Primary practice location

101 W. Thornton
Three Rivers, TX 78071

Mailing address

813 Hospital Dr.
Andrews, TX 79714
Phone (432) 523-4861

Other identifiers

IdentifierTypeStateIssuer
149919MedicaidTX

Other names

  • Campbell Drug Store Doing business as

Other providers in Three Rivers, TX

All providers in Three Rivers, TX · Community/Retail Pharmacy in Texas

Sources for this page

Verify at the official NPI Registry.