Provider Demographics
NPI:1750509709
Name:PEOPLES PHARMACY
Entity Type:Organization
Organization Name:PEOPLES PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ACCOUNTS RECEIVABLE
Authorized Official - Prefix:
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:NICOLOFF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-447-1799
Mailing Address - Street 1:4018 NORTH LAMAR BLVD
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78756
Mailing Address - Country:US
Mailing Address - Phone:512-459-9090
Mailing Address - Fax:512-371-1246
Practice Address - Street 1:4018 N LAMAR BLVD
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-3714
Practice Address - Country:US
Practice Address - Phone:512-459-9090
Practice Address - Fax:512-371-1246
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-23
Last Update Date:2016-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX053343336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy