Provider Demographics
NPI:1972514529
Name:CENTER PHARMACY INC
Entity Type:Organization
Organization Name:CENTER PHARMACY INC
Other - Org Name:CENTER PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:MYRON
Authorized Official - Middle Name:
Authorized Official - Last Name:REPKA
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:830-569-2512
Mailing Address - Street 1:105 N SMITH ST
Mailing Address - Street 2:
Mailing Address - City:PLEASANTON
Mailing Address - State:TX
Mailing Address - Zip Code:78064-4109
Mailing Address - Country:US
Mailing Address - Phone:830-569-2512
Mailing Address - Fax:830-569-2914
Practice Address - Street 1:105 N SMITH ST
Practice Address - Street 2:
Practice Address - City:PLEASANTON
Practice Address - State:TX
Practice Address - Zip Code:78064-4109
Practice Address - Country:US
Practice Address - Phone:830-569-2512
Practice Address - Fax:830-569-2914
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2016-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
TX155553336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2098880OtherPK