Individual provider · Type 1 NPI
Derek Madison Ethridge, RPH
Pharmacist · Lytle, TX
Practice location
19450 Mcdonald St Ste 102
Lytle, TX 78052-3649
Fax (830) 988-0111
Mailing address
1757 Sunflower Blf
New Braunfels, TX 78130-1958
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Pharmacist Primary | 183500000X | 30227 (TX) |
Pharmacist: An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage…
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About NPI 1700478575
Derek Madison Ethridge, RPH's National Provider Identifier is 1700478575, issued on Feb 3, 2021. The primary taxonomy on file is Pharmacist (183500000X), and the practice location is in Lytle, TX. The record was last updated on Feb 3, 2021.