Organization
POLK PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VINCENT IFEANYI CHUKWUKELU R.PH (PHARMACIST-IN-CHARGE)
(972) 247-4322
Entity
Organization
Contact information
Practice address
8 MEDICAL PKWY, PLAZA 11, SUITE 106, FARMERS BRANCH, TX 75234
(972) 247-4322
(972) 247-4320
Mailing address
502 GREENWICH LANE, COPPELL, TX 75019
(972) 247-4322
(972) 247-4320
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
15644
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
114159
—
TX
Enumeration date
02/09/2007
Last updated
09/17/2014
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