# MOUNTAIN CARE PHARMACY TEXAS LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Mountain Care Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1578805172
- **Authorized official:** DALE ALLRED (VP OPERATIONS)
- **Authorized official phone:** (801) 747-7191

## Contact information

- **Practice address:** 2010 CENTURY CENTER BLVD STE J, IRVING, TX 75062-4963
- **Practice address phone:** (972) 536-1986
- **Practice address fax:** (972) 579-8048
- **Mailing address:** 1030 W BELLWOOD LN, MURRAY, UT 84123-4494
- **Mailing address phone:** (801) 747-7191
- **Mailing address fax:** (801) 747-7192

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0004X | Compounding Pharmacy | — | NULL | — |
| 3336H0001X | Home Infusion Therapy Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | 28433 | TX | Yes |

## Other

- **Enumeration date:** 03/21/2013
- **Last updated:** 09/20/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2139306 | PK | — |