Provider Demographics
NPI:1992318760
Name:NEVATEX PHARMACY LLC
Entity type:Organization
Organization Name:NEVATEX PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KELLY
Authorized Official - Middle Name:
Authorized Official - Last Name:TOMLINSON
Authorized Official - Suffix:
Authorized Official - Credentials:CPHT
Authorized Official - Phone:903-900-0776
Mailing Address - Street 1:6465 STATE HWY 78
Mailing Address - Street 2:SUITE 105
Mailing Address - City:NEVADA
Mailing Address - State:TX
Mailing Address - Zip Code:75173
Mailing Address - Country:US
Mailing Address - Phone:866-949-9999
Mailing Address - Fax:903-375-0406
Practice Address - Street 1:6465 STATE HWY 78
Practice Address - Street 2:SUITE 105
Practice Address - City:NEVADA
Practice Address - State:TX
Practice Address - Zip Code:75173
Practice Address - Country:US
Practice Address - Phone:866-949-9999
Practice Address - Fax:903-375-0406
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-31
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy