Organization
EXECUTIVE HEALTHCARE
Active
Other names
The Apothecary Shop
Organization subpart
No
Provider details
NPI number
Authorized official
SEMYON NAROSOV (OWNER)
(214) 357-8889
Entity
Organization
Contact information
Practice address
6303 FOREST PARK RD, STE A 255, DALLAS, TX 75235-5450
(214) 357-8889
(214) 357-8370
Mailing address
PO BOX 797604, DALLAS, TX 75379-7604
(972) 702-9310
(972) 458-7111
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
26627
TX
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2091865
PK
—
Enumeration date
09/25/2006
Last updated
12/10/2015
About Stedi
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