Organization
OMEGA PHARMACY INC
Active
Other names
OMEGA PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
ANTHONY OGBOLU (MD/PIC)
(214) 676-6531
Entity
Organization
Contact information
Practice address
4507 MAPLE AVE STE 100, DALLAS, TX 75219-1830
(214) 599-8844
(214) 443-8121
Mailing address
4507 MAPLE AVE STE 100, DALLAS, TX 75219-1830
(214) 599-8844
(214) 443-8121
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28258
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
146652
—
TX
01
—
2136075
PK
—
Enumeration date
07/12/2012
Last updated
02/14/2017
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