Organization
A-CLASS PARK PLACE PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAM SALEH (CORPORATE OFFICER)
(817) 862-9110
Entity
Organization
Contact information
Practice address
1001 12TH AVE STE 156, FORT WORTH, TX 76104-3929
(817) 862-9110
Mailing address
1001 12TH AVE STE 156, FORT WORTH, TX 76104-3929
(817) 862-9110
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
Other
Enumeration date
05/09/2018
Last updated
08/13/2020
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