Organization
BAYLOR SCOTT & WHITE HEALTH ENTERPRISES, INC.
Active
Other names
Baylor Scott & White Pharmacy #102
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY COHEN (PRESIDENT)
(214) 865-3669
Entity
Organization
Contact information
Practice address
1250 8TH AVE, STE 125, FORT WORTH, TX 76104
(817) 922-3800
(817) 922-3801
Mailing address
PO BOX 847670, DALLAS, TX 75284-7670
(817) 922-3800
(817) 922-3801
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
26176
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2117166
PK
—
05
—
470200
—
TX
Enumeration date
09/29/2008
Last updated
04/24/2025
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