Marilyn Devere

Organization Active NPI Community/Retail Pharmacy · Luling, TX

NPI 1942652979 · NPPES record last updated Jul 1, 2016

Key facts

NPI
1942652979
Entity type
Organization (NPI type 2)
Primary specialty
Community/Retail Pharmacy 3336C0003X
License
30810 (TX)
Legal business name
MARILYN DEVERE
Practice address
511 E Davis St
Luling, TX 78648-2317
Phone
(830) 875-2811
Fax
(830) 875-2283
NPI assigned
Jul 1, 2016
Organization subpart
No

Authorized official

Name
Marilyn Devere
Title
Owner
Phone
(830) 875-2811

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
Dismukes Pharmacy (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 30810 TX Yes

Addresses

Primary practice location

511 E Davis St
Luling, TX 78648-2317

Mailing address

511 E Davis St
Luling, TX 78648-2317
Phone (830) 875-2811

Other identifiers

IdentifierTypeStateIssuer
145690MedicaidTX

Other names

  • Dismukes Pharmacy Doing business as

Other providers in Luling, TX

All providers in Luling, TX · Community/Retail Pharmacy in Texas

Sources for this page

Verify at the official NPI Registry.