Provider Demographics
NPI:1336524438
Name:BRACE PHARMACIES, LLC
Entity Type:Organization
Organization Name:BRACE PHARMACIES, LLC
Other - Org Name:LIBERTY HILL PHARMACY AND COMPOUNDING CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:DR
Authorized Official - First Name:WHITNEY
Authorized Official - Middle Name:LORRAINE
Authorized Official - Last Name:BRACE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:512-766-5479
Mailing Address - Street 1:13740 W STATE HIGHWAY 29 STE 4
Mailing Address - Street 2:PO BOX 700
Mailing Address - City:LIBERTY HILL
Mailing Address - State:TX
Mailing Address - Zip Code:78642-6283
Mailing Address - Country:US
Mailing Address - Phone:512-766-5479
Mailing Address - Fax:
Practice Address - Street 1:13740 W STATE HIGHWAY 29 STE 4
Practice Address - Street 2:
Practice Address - City:LIBERTY HILL
Practice Address - State:TX
Practice Address - Zip Code:78642-6283
Practice Address - Country:US
Practice Address - Phone:512-766-5479
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-30
Last Update Date:2015-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX301183336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy