Organization
BLUEGREEN INDUSTRIES LLC
Active
Other names
WHEATLAND PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
LYNN CLARK (PIC)
(972) 572-1500
Entity
Organization
Contact information
Practice address
1666 N HAMPTON RD STE 100B, DESOTO, TX 75115-8627
(972) 572-1500
(972) 572-1505
Mailing address
PO BOX 765311, DALLAS, TX 75376-5311
(972) 572-1500
(972) 572-1505
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
26621
TX
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
146063
—
TX
01
—
2121875
PK
—
Enumeration date
09/08/2009
Last updated
07/26/2013
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us