Organization
AYDIL RX SERVICES, LLC
Active
Other names
Medicine Shoppe #2015
Organization subpart
No
Provider details
NPI number
Authorized official
VIMAL BHAKTA RPH (MANAGING MEMBER)
(972) 839-0724
Entity
Organization
Contact information
Practice address
3001 JOE RAMSEY BLVD E, GREENVILLE, TX 75401-7714
(903) 455-7200
(903) 455-7300
Mailing address
1440 GARDENIA ST, IRVING, TX 75063-4232
(972) 839-0724
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
29403
TX
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2146060
PK
—
Enumeration date
08/07/2014
Last updated
01/10/2021
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