Organization
BAYLOR SCOTT & WHITE HEALTH ENTERPRISES, INC.
Active
Organization
BAYLOR SCOTT & WHITE HEALTH ENTERPRISES, INC.
Active
Other names
Baylor Scott & White Pharmacy #111
Organization subpart
No
Provider details
NPI number
Authorized official
TAMMY COHEN (PRESIDENT)
(214) 865-3669
Entity
Organization
Contact information
Practice address
3417 GASTON AVE STE 195, DALLAS, TX 75246-2016
(214) 818-1611
(214) 818-1612
Mailing address
PO BOX 847670, DALLAS, TX 75284-7670
(214) 818-1611
(214) 818-1612
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
30929
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2159029
PK
—
05
—
471152
—
TX
Enumeration date
04/06/2016
Last updated
04/24/2025
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