NPI 1144845827 · live from the CMS NPI Registry
62 Roses Wellness, LLC
Pharmacy, Community/Retail Pharmacy in Tyler, TX. National Provider Identifier 1144845827, active.
NPI record
| NPI | 1144845827 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Pharmacy, Community/Retail Pharmacy 3336C0003X |
| Practice location | 3320 Troup Hwy Ste 140, Tyler, TX 75701 |
| Practice phone | 682-207-1232 |
| Mailing address | 1620 W Northwest Hwy Ste 100, Grapevine, TX 76051 |
| Enumerated | June 9, 2020 |
| Last updated | June 9, 2020 |
| Authorized official | Gary Baxter, Ceo |
| Other names | 24 Wellness Rx |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pharmacy | 333600000X | — |
| Pharmacy, Compounding Pharmacy | 3336C0004X | — |
| Pharmacy, Community/Retail Pharmacy primary | 3336C0003X | — |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.