Organization
IDEAL SPECIALTY PHARMACY, LLC
Active
Other names
Professional Pharmacy Plus
Organization subpart
No
Provider details
NPI number
Authorized official
VIN NGUYEN (DIRECTOR)
(972) 809-0984
Entity
Organization
Contact information
Practice address
400 W ARBROOK BLVD STE 111, ARLINGTON, TX 76014-3175
(972) 809-0984
(972) 809-0986
Mailing address
400 W ARBROOK BLVD STE 111, ARLINGTON, TX 76014-3175
(972) 809-0984
(972) 809-0986
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
31460
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
31460
STATE LIC
TX
01
—
5921665
NCPDP
TX
Enumeration date
07/10/2017
Last updated
03/07/2023
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