CITY DRUG JEFFERSON TEXAS INC
109 W Lafayette St
Jefferson, TX 75657
903-665-2521
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
N | 3336L0003X | Suppliers - Pharmacy - Long Term Care Pharmacy | ||
Y | 3336C0003X | Suppliers - Pharmacy | TX | 00141 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
17946601 | TX | MEDICAID | |
120423 | TX | MEDICAID |