Provider Demographics
NPI:1700166170
Name:SIGNA PHARMACY GROUP, LLC
Entity Type:Organization
Organization Name:SIGNA PHARMACY GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KEELY
Authorized Official - Middle Name:M
Authorized Official - Last Name:ARTHO
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:806-353-7712
Mailing Address - Street 1:1901 MEDI PARK DR STE 120
Mailing Address - Street 2:
Mailing Address - City:AMARILLO
Mailing Address - State:TX
Mailing Address - Zip Code:79106-2106
Mailing Address - Country:US
Mailing Address - Phone:806-353-7712
Mailing Address - Fax:806-353-7713
Practice Address - Street 1:1901 MEDI PARK DR STE 120
Practice Address - Street 2:
Practice Address - City:AMARILLO
Practice Address - State:TX
Practice Address - Zip Code:79106-2106
Practice Address - Country:US
Practice Address - Phone:806-353-7712
Practice Address - Fax:806-353-7713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-17
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX276003336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX27600OtherTEXAS STATE BOARD OF PHARMACY
TX351016Medicaid