Provider Demographics
NPI:1629601489
Name:GOODVALUE PHARMACY LLC
Entity Type:Organization
Organization Name:GOODVALUE PHARMACY LLC
Other - Org Name:GOODVALUE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:AMRISH
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:430-562-9003
Mailing Address - Street 1:3401 FM 3009 STE 100
Mailing Address - Street 2:
Mailing Address - City:SCHERTZ
Mailing Address - State:TX
Mailing Address - Zip Code:78154-2711
Mailing Address - Country:US
Mailing Address - Phone:210-903-6822
Mailing Address - Fax:210-903-6968
Practice Address - Street 1:3401 FM 3009 STE 100
Practice Address - Street 2:
Practice Address - City:SCHERTZ
Practice Address - State:TX
Practice Address - Zip Code:78154-2711
Practice Address - Country:US
Practice Address - Phone:210-903-6822
Practice Address - Fax:210-903-6968
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-19
Last Update Date:2023-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX33980OtherTEXAS STATE BOARD OF PHARMACY PHARMACY LICENSE