Organization
SMA GROUP INCORPORATED
Active
Organization
SMA GROUP INCORPORATED
Active
Other names
SMA pharmacy#10, SMA pharmacy #1
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BINTA IDODO PHARMD (OWNER)
(214) 316-2574
Entity
Organization
Contact information
Practice address
1110 E PLEASANT RUN RD, DESOTO, TX 75115
(972) 274-0256
(972) 274-0521
Mailing address
PO BOX 1893, MANSFIELD, TX 76063-0017
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
25992
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2101283
PK
—
Enumeration date
05/02/2008
Last updated
08/08/2017
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