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Organization
PHARMACY CARE USA OF ADDISON, LLC
Active
Organization
PHARMACY CARE USA OF ADDISON, LLC
Active
Other names
Pharmacy Care USA of Addison, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DORIS PETEK-GOMERSALL (SVP CORPORATE COMPLIANCE)
(970) 250-2044
Entity
Organization
Contact information
Practice address
4500 RATLIFF LANE, SUITE 102, ADDISON, TX 75001
(972) 388-1800
(877) 505-7999
Mailing address
P.O. BOX 365, HYDRO, OK 73048
(972) 388-1800
(877) 505-7999
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
—
NULL
3336L0003X
Long Term Care Pharmacy
Primary
28672
TX
3336L0003X
Long Term Care Pharmacy
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2141466
PK
—
Enumeration date
08/14/2013
Last updated
02/28/2019
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