Organization
QVL PHARMACY 147 LLC
Active
Other names
QVL Pharmacy #147
Organization subpart
No
Provider details
NPI number
Authorized official
GARY CHAD COLLINS (CEO)
(214) 624-3050
Entity
Organization
Contact information
Practice address
3751 MATLOCK RD STE 121, ARLINGTON, TX 76015-4342
(682) 300-2303
(682) 300-2304
Mailing address
PO BOX 803493, DALLAS, TX 75380-3493
(214) 624-3073
(214) 989-7986
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28346
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2138018
PK
—
05
—
466884
—
TX
Enumeration date
12/03/2012
Last updated
06/17/2014
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