Organization
DALLAS COUNTY MENTAL HEALTH & MENTAL RETARDATION CENTER
Active
Other names
Metrocare Pharmacy at Midway
Organization subpart
No
Provider details
NPI number
Authorized official
MORDECHAI EDERY (DIRECTOR OF PHARMACY)
(214) 743-6180
Entity
Organization
Contact information
Practice address
16160 MIDWAY RD STE 200, ATTN: PHARMACY, ADDISON, TX 75001-4202
(972) 331-6370
(214) 330-2491
Mailing address
16160 MIDWAY RD STE 200, ATTN: PHARMACY, ADDISON, TX 75001-4202
(972) 331-6370
(214) 330-2491
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
Primary
29518
TX
3336M0002X
Mail Order Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2148001
PK
—
Enumeration date
09/22/2014
Last updated
03/06/2017
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