1568632545 NPI number — PHARMED L.P.

Table of content: (NPI 1568632545)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568632545 NPI number — PHARMED L.P.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PHARMED L.P.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
FAMILY CARE PHARMACY #3
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1568632545
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/17/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 260329
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PLANO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
75026-0329
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
972-596-6690
Provider Business Mailing Address Fax Number:
972-596-6696

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2959 S BUCKNER BLVD
Provider Second Line Business Practice Location Address:
STE 700
Provider Business Practice Location Address City Name:
DALLAS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
75227-6945
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
469-916-0190
Provider Business Practice Location Address Fax Number:
469-916-0191
Provider Enumeration Date:
03/06/2008

Additional Information

Authorized Official

Authorized Official Last Name:
DAVANI
Authorized Official First Name:
SAEID
Authorized Official Middle Name:
Authorized Official Title or Position:
PARTNER
Authorized Official Telephone Number:
972-596-6690

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  24997 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 068227002 . This is a "TPI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 145662 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1811918873 . This is a "NPI" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 4540957 . This is a "NCPDP" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".




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