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Organization
WESTPARK DISCOUNT PHARMACY INC
Active
Organization
WESTPARK DISCOUNT PHARMACY INC
Active
Other names
DYM Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
EMMANUEL EGENTI (PRESIDENT /CEO)
(817) 571-9100
Entity
Organization
Contact information
Practice address
5017 HERITAGE AVE STE CON1, COLLEYVILLE, TX 76034-5994
(817) 571-9100
(817) 571-9131
Mailing address
6913 BERNADINE DR, WATAUGA, TX 76148-2165
(817) 571-9100
(817) 571-9131
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
28568
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2140516
PK
—
Enumeration date
05/24/2013
Last updated
06/16/2015
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