Provider Demographics
NPI:1538203807
Name:MOHRMANN'S DRUG STORE LLC
Entity type:Organization
Organization Name:MOHRMANN'S DRUG STORE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER-PIC
Authorized Official - Prefix:MR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:MARVIN
Authorized Official - Last Name:MOHRMANN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:830-672-2317
Mailing Address - Street 1:2405 WINDING WAY DR
Mailing Address - Street 2:
Mailing Address - City:GONZALES
Mailing Address - State:TX
Mailing Address - Zip Code:78629-3246
Mailing Address - Country:US
Mailing Address - Phone:830-672-2317
Mailing Address - Fax:830-672-9593
Practice Address - Street 1:2405 WINDING WAY DR
Practice Address - Street 2:
Practice Address - City:GONZALES
Practice Address - State:TX
Practice Address - Zip Code:78629-3246
Practice Address - Country:US
Practice Address - Phone:830-672-2317
Practice Address - Fax:830-672-9593
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-19
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336L0003X
TX287513336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy