1447547286 NPI number — GREEN OAKS PHARMA INC.

Table of content: (NPI 1447547286)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447547286 NPI number — GREEN OAKS PHARMA INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GREEN OAKS PHARMA INC.
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:
DFW WELLNESS PHARMACY
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:
1447547286
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/30/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
711 E. LAMAR BLVD
Provider Second Line Business Mailing Address:
SUITE # 101
Provider Business Mailing Address City Name:
ARLINGTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76011-3888
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
817-459-8400
Provider Business Mailing Address Fax Number:
817-459-8402

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
711 E. LAMAR BLVD
Provider Second Line Business Practice Location Address:
SUITE # 101
Provider Business Practice Location Address City Name:
ARLINGTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76011-3888
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
817-459-8400
Provider Business Practice Location Address Fax Number:
817-459-8402
Provider Enumeration Date:
06/30/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
PATEL
Authorized Official First Name:
PRAFUL
Authorized Official Middle Name:
D
Authorized Official Title or Position:
VICE PRESIDENT
Authorized Official Telephone Number:
214-457-5571

Provider Taxonomy Codes

  • Taxonomy code: 333600000X , 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)