Organization
PROSPER PHARMACY LLC
Active
Organization
PROSPER PHARMACY LLC
Active
Other names
Prosper Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
ADI GELLI (CORPORATE MANAGER)
(214) 338-4010
Entity
Organization
Contact information
Practice address
1000 PRESTON RD N, SUITE 10, PROSPER, TX 75078-8779
(214) 338-4010
(214) 338-4011
Mailing address
1000 PRESTON RD N, SUITE 10, PROSPER, TX 75078-8779
(214) 338-4010
(214) 338-4011
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
29623
TX
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2148612
PK
—
Enumeration date
10/31/2014
Last updated
12/08/2014
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