Organization
SOUTH SCRIPT HEALTH CARE INC
Active
Other names
PARK PLACE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MONIQUE NICHOLSON RPH (CEO)
(817) 924-9292
Entity
Organization
Contact information
Practice address
1601 PARK PLACE AVE, STE B, FORT WORTH, TX 76110-1303
(817) 924-9292
(817) 924-9264
Mailing address
1601 PARK PLACE AVE, STE B, FORT WORTH, TX 76110-1303
(817) 924-9292
(817) 924-9264
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
23988
TX
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
145526
—
TX
01
—
2096886
PK
—
Enumeration date
07/30/2006
Last updated
01/13/2017
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