Wellformed AI

NPI 1285405860 · live from the CMS NPI Registry

1918 Winter Street Operating Co LLC

Pharmacy, Community/Retail Pharmacy in Mansfield, TX. National Provider Identifier 1285405860, active.

NPI record

NPI1285405860 Type 2 · organization
StatusActive
Primary specialtyPharmacy, Community/Retail Pharmacy 3336C0003X
Practice location3145 E Broad St, Mansfield, TX 76063
Practice phone817-453-6015
Mailing address7 Corporate Dr, Keene, NH 03431
EnumeratedJanuary 11, 2024
Last updatedJuly 24, 2024
Authorized officialKevin Mcnamara, Authorized Person
Other namesMarket Street Pharmacy #0696

Taxonomies and licenses

TaxonomyCodeLicense
Pharmacy333600000X—
Pharmacy, Community/Retail Pharmacy primary3336C0003X—

Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.