Organization
FAVOS INCORPORATED
Active
Other names
TRINITY NORTH PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
NIKI AKINSEYE (PHARMACIST IN CHARGE)
(469) 348-1038
Entity
Organization
Contact information
Practice address
6053 MAIN ST, SUITE 120, THE COLONY, TX 75056-2062
(214) 494-6222
(214) 494-6223
Mailing address
6053 MAIN ST, SUITE 120, THE COLONY, TX 75056-2062
(214) 494-6222
(214) 494-6223
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
27417
TX
3336L0003X
Long Term Care Pharmacy
—
—
3336M0003X
Managed Care Organization Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5902780
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
02/08/2011
Last updated
10/22/2013
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