Qvl Pharmacy 102

LBN: Ss Tyler Lp
Qvl Pharmacy 102 is an health care organization with primary practice located at 1321 S Beckham Ave , Tyler TX 75701-3323. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Ss Tyler Lp can be contacted via phone (903) 593-1706, or through Collins, Gary Chad via phone (214) 624-3050.

Contact Information

Primary practice address
1321 S Beckham Ave Tyler TX 75701-3323
Phone: (903) 593-1706
Fax: (903) 593-5513
Website:
Map and Directions
Authorized official contact:
Name: Collins, Gary Chad
Phone: (214) 624-3050

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 23909 Texas

Profile Details

NPI number 1477505618
LBN Legal business name Ss Tyler Lp
DBA Doing business as Qvl Pharmacy 102
Authorized official Collins, Gary Chad
Entity Organization
Organization subpart 1 No
Enumeration date May 16th, 2006
Last updated Jun 17th, 2014 - about 10 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1477505618 NPPES
Other 2097627 PK
MEDICAID 145570 PK

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