Organization
MOUNTAIN CARE PHARMACY TEXAS LLC
Active
Other names
Mountain Care Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DALE ALLRED (VP OPERATIONS)
(801) 747-7191
Entity
Organization
Contact information
Practice address
2010 CENTURY CENTER BLVD STE J, IRVING, TX 75062-4963
(972) 536-1986
(972) 579-8048
Mailing address
1030 W BELLWOOD LN, MURRAY, UT 84123-4494
(801) 747-7191
(801) 747-7192
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
28433
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2139306
PK
—
Enumeration date
03/21/2013
Last updated
09/20/2013
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