Organization
DOUGHERTYS PHARMACY LEGACY LLC
Active
Other names
Dougherty's Pharmacy on Legacy
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN PETTIT (DIRECTOR OF PHARMACY OPERATIONS)
(972) 860-0229
Entity
Organization
Contact information
Practice address
6501 LEGACY DR STE P, PLANO, TX 75024-3612
(214) 884-1929
(214) 884-1931
Mailing address
6501 LEGACY DR STE P, PLANO, TX 75024-3612
(214) 884-1929
(214) 884-1931
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2177616
PK
—
Enumeration date
05/09/2018
Last updated
05/23/2018
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