Organization
LIFESPAN PHARMACY INC
Active
Other names
LIFESPAN PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
GINA RENNA PHARMACIST (OWNER/OFFICER)
(214) 303-1888
Entity
Organization
Contact information
Practice address
1341 W MOCKINGBIRD LN, SUITE 304W, DALLAS, TX 75247
(214) 220-0007
(214) 220-2850
Mailing address
1341 W MOCKINGBIRD LN, SUITE 304W, DALLAS, TX 75247
(214) 220-0007
(214) 220-2850
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
TX
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
24217
TX
3336S0011X
Specialty Pharmacy
Primary
—
TX
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4525688
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
04/01/2008
Last updated
08/16/2018
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up