Organization
PHARMACY CARE USA OF ADDISON, LLC
Active
Other names
Pharmacy Care USA of Addison, LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DORIS PETEK-GOMERSALL (SVP CORPORATE COMPLIANCE)
(970) 250-2044
Entity
Organization
Contact information
Practice address
4500 RATLIFF LANE, SUITE 102, ADDISON, TX 75001
(972) 388-1800
(877) 505-7999
Mailing address
P.O. BOX 365, HYDRO, OK 73048
(972) 388-1800
(877) 505-7999
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
28672
TX
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2141466
PK
—
Enumeration date
08/14/2013
Last updated
02/28/2019
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