Individual ProviderKaren A GreenPharmacistPharmacy Service ProvidersPractice Address6801 S Broadway Ave, Tyler, TX 75703-4733(903) 581-4842PECOS EnrollmentBased on the most recent information from CMS, provider Karen A Green does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1417557158Provider TypeIndividualFull NameGreen, Karen ACredentialPHARMACISTGenderFemaleSole ProprietorNoEnumeration Date10/30/2020Last Updated10/30/2020Contact InformationPractice LocationPractice Address6801 S Broadway Ave, Tyler, TX 75703-4733Phone(903) 581-4842Fax(903) 939-8937Mailing LocationMailing Address6801 S Broadway Ave, Tyler, TX 75703-4733Phone(903) 581-4842Fax(903) 939-8937Provider TaxonomiesCodeDescriptionLicenseCode183500000XPrimaryDescriptionPharmacistPharmacy Service ProvidersLicense28472Texas