| Organization Name: | ALEDO MEDICINE STORE INC |
| NPI Number: | 1245360700 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | PRESTON HALL (PRESIDENT) |
| Mailing Address: | 621 North F M 1187 Aledo |
| State: | TX US |
| Postal Code: | 760084206 |
| Phone Number: | 8174412702 |
| Fax Number: | 8174412708 |
| NPI Enumeration Date: | 03/06/2007 |
| NPI Last Update Date: | 09/05/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 3336C0004X |
| License Number: | 23774 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | TX |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Pharmacy |
| Taxonomy Specialization: | Compounding Pharmacy |
| Taxonomy Definition: | A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner |