Your New Waverly Pharmacy Llc

LBN: Your New Waverly Pharmacy Llc
Your New Waverly Pharmacy Llc is an health care organization with primary practice located at 9320C State Highway 75 S , New Waverly TX 77358-4224. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Your New Waverly Pharmacy Llc can be contacted via phone (936) 344-2424, or through Wilt, Bill via phone (281) 804-3234.

Contact Information

Primary practice address
9320C State Highway 75 S New Waverly TX 77358-4224
Phone: (936) 344-2424
Fax: (936) 344-2428
Website:
Map and Directions
Authorized official contact:
Name: Wilt, Bill
Phone: (281) 804-3234

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 28286 Texas
Suppliers / Compounding Pharmacy 3336C0004X

Profile Details

NPI number 1912250507
LBN Legal business name Your New Waverly Pharmacy Llc
DBA Doing business as Your New Waverly Pharmacy Llc
Authorized official Wilt, Bill
Entity Organization
Organization subpart 1 No
Enumeration date Oct 19th, 2012
Last updated Oct 19th, 2020 - about 5 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 1912250507 NPPES
Other 5907273 NCPDP PROVIDER IDENTIFICATION NUMBER

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