Organization
SOUTHERN STAR PHARMACY 002
Active
Organization
SOUTHERN STAR PHARMACY 002
Active
Other names
AD Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
SYEDA SAIMA AHMED RPH (DIRECTOR OF PHARMACY)
(972) 677-7891
Entity
Organization
Contact information
Practice address
2698 N GALLOWAY AVE STE 108, MESQUITE, TX 75150-6390
(469) 646-6057
(877) 743-4398
Mailing address
2698 N GALLOWAY AVE STE 108, MESQUITE, TX 75150-6390
(469) 646-6057
(877) 743-4398
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33256
TX BOP
TX
01
—
5931503
NCPDP
—
Enumeration date
06/02/2020
Last updated
03/17/2026
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