Provider Demographics
NPI:1760685200
Name:TODD CLINIC PHARMACY
Entity Type:Organization
Organization Name:TODD CLINIC PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CHESTER
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:TODD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:830-683-3333
Mailing Address - Street 1:105 SWEETEN ST
Mailing Address - Street 2:
Mailing Address - City:ROCKSPRINGS
Mailing Address - State:TX
Mailing Address - Zip Code:78880-0918
Mailing Address - Country:US
Mailing Address - Phone:830-683-3333
Mailing Address - Fax:830-683-4140
Practice Address - Street 1:105 SWEETEN ST
Practice Address - Street 2:
Practice Address - City:ROCKSPRINGS
Practice Address - State:TX
Practice Address - Zip Code:78880-0918
Practice Address - Country:US
Practice Address - Phone:830-683-3333
Practice Address - Fax:830-683-4140
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXD2032183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXB27009Medicare UPIN