Provider Demographics
NPI:1942084447
Name:TOWER MEDIC PHARMACY INC
Entity Type:Organization
Organization Name:TOWER MEDIC PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MELVIN
Authorized Official - Middle Name:BRUCE
Authorized Official - Last Name:MUSGROVE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:817-336-8133
Mailing Address - Street 1:607 W MAGNOLIA AVE STE B
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76104-4608
Mailing Address - Country:US
Mailing Address - Phone:817-336-8133
Mailing Address - Fax:
Practice Address - Street 1:607 W MAGNOLIA AVE STE B
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76104-4608
Practice Address - Country:US
Practice Address - Phone:817-336-8133
Practice Address - Fax:817-314-7227
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TOWER MEDIC PHARMACY INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2023-08-24
Last Update Date:2023-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy