Provider Demographics
NPI:1275962961
Name:PATIENT FIRST CHOICE PHARMACY
Entity Type:Organization
Organization Name:PATIENT FIRST CHOICE PHARMACY
Other - Org Name:TRUKARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:TRUMAN WARREN
Authorized Official - Middle Name:
Authorized Official - Last Name:WARREN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-277-2402
Mailing Address - Street 1:1008 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:LIBERTY
Mailing Address - State:TX
Mailing Address - Zip Code:77575-3718
Mailing Address - Country:US
Mailing Address - Phone:936-641-9395
Mailing Address - Fax:936-641-9397
Practice Address - Street 1:1008 MAIN ST
Practice Address - Street 2:
Practice Address - City:LIBERTY
Practice Address - State:TX
Practice Address - Zip Code:77575-3718
Practice Address - Country:US
Practice Address - Phone:936-641-9395
Practice Address - Fax:936-641-9397
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-04
Last Update Date:2013-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX288483336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2142782OtherPK