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Organization
MOUNTAIN CARE PHARMACY TEXAS LLC
Active
Organization
MOUNTAIN CARE PHARMACY TEXAS LLC
Active
Other names
Mountain Care Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DALE ALLRED (VP OPERATIONS)
(801) 747-7191
Entity
Organization
Contact information
Practice address
2010 CENTURY CENTER BLVD STE J, IRVING, TX 75062-4963
(972) 536-1986
(972) 579-8048
Mailing address
1030 W BELLWOOD LN, MURRAY, UT 84123-4494
(801) 747-7191
(801) 747-7192
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0004X
Compounding Pharmacy
—
NULL
3336H0001X
Home Infusion Therapy Pharmacy
—
NULL
3336L0003X
Long Term Care Pharmacy
Primary
28433
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2139306
PK
—
Enumeration date
03/21/2013
Last updated
09/20/2013
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