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Organization
DERAMED LTC PHARMACY
Active
Organization
DERAMED LTC PHARMACY
Active
Parent organization
DERHANN CO. LLC
Other names
DeraMed Specialty Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
DERHANN CO. LLC
Authorized official
ADERONKE EFUNOGBON (DIRECTOR)
(817) 592-3636
Entity
Organization
Contact information
Practice address
1001 MATLOCK RD STE 105, MANSFIELD, TX 76063-3443
(817) 592-3636
Mailing address
1001 MATLOCK RD STE 105, MANSFIELD, TX 76063-3443
(817) 592-3636
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
—
NULL
3336S0011X
Specialty Pharmacy
—
NULL
Other
Enumeration date
07/06/2020
Last updated
05/03/2024
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