Organization
LONG PRAIRIE PHARMACY LLC
Active
Other names
Long Prairie Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
PRAFUL PATEL (OWNER)
(972) 410-3773
Entity
Organization
Contact information
Practice address
4921 LONG PRAIRIE RD STE 105, SUITE 105, FLOWER MOUND, TX 75028-2742
(972) 410-3773
(972) 410-3776
Mailing address
4921 LONG PRAIRIE RD, SUITE 105, FLOWER MOUND, TX 75028-2716
(972) 410-3773
(972) 410-3776
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
27944
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
146586
—
TX
01
—
2134230
PK
—
Enumeration date
03/07/2012
Last updated
10/26/2013
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