Organization · NPI-2

3 Wild Ones LLC

Pharmacy, Community/Retail Pharmacy · San Antonio, TX

NPI number1134540917
StatusActive
Last updated in NPPESMar 19, 2025

Details

NPI
1134540917
Entity type
Organization (NPI-2)
Legal business name
3 Wild Ones LLC
Organization subpart
No
Enumeration date
Dec 23, 2013
Certification date
Mar 19, 2025
Last updated
Mar 19, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
3336C0003X Pharmacy, Community/Retail Pharmacy––Yes

Other names

  • Good Life Pharmacy (Doing Business As)

Practice location

26108 Overlook Pkwy
Bldg 4
San Antonio, TX 78260

Phone 210-819-4515 · Fax 210-819-4516

Mailing address

33 Sulfur Cyn
San Antonio, TX 78247

Phone 504-481-5364 · Fax 210-819-4516

Authorized official

Christopher Michael Louis Berard
Owner
5044815364

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