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Organization
TELESIS-WALNUT PLACE NURSING HOME I LTD
Active
Organization
TELESIS-WALNUT PLACE NURSING HOME I LTD
Active
Other names
Walnut Place Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROLIN SAMUEL GREEN JR. (PHARMACIST AND MANAGER)
(214) 361-8923
Entity
Organization
Contact information
Practice address
5515 GLEN LAKES DR, DALLAS, TX 75231-4309
(214) 361-8923
(214) 361-4281
Mailing address
5515 GLEN LAKES DR, DALLAS, TX 75231-4309
(214) 361-8923
(214) 361-4281
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336L0003X
Long Term Care Pharmacy
Primary
11588
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4571938
OTHER ID NUMBER
—
Enumeration date
09/13/2006
Last updated
10/08/2008
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