Organization · NPI-2
Abeldt Enterprises
Pharmacy, Community/Retail Pharmacy · Tyler, TX
NPI number1407874936
StatusActive
Last updated in NPPESJun 24, 2020
Details
- NPI
- 1407874936
- Entity type
- Organization (NPI-2)
- Legal business name
- Abeldt Enterprises
- Organization subpart
- No
- Enumeration date
- Jul 17, 2006
- Certification date
- Jun 24, 2020
- Last updated
- Jun 24, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3336C0003X | Pharmacy, Community/Retail Pharmacy | 21015 | TX | Yes |
| 332B00000X | Durable Medical Equipment & Medical Supplies | – | – |
Other names
- Brick Street Pharmacy (Doing Business As)
Practice location
314 W Rusk StTyler, TX 75701-1513
Phone 903-533-8155 · Fax 903-533-8158
Mailing address
314 W Rusk StTyler, TX 75701-1513
Phone 903-533-8155 · Fax 903-533-8158
Authorized official
Jeffrey Abeldt
Owner
9035338155
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