Organization
TRIWEST SPECIALTY PHARMACY LP
Active
Other names
TRIWEST Specialty Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
UMAIR AHMAD (OFFICER)
(214) 226-2973
Entity
Organization
Contact information
Practice address
1940 ENCHANTED WAY STE 103A, GRAPEVINE, TX 76051-0965
(972) 914-4990
(214) 461-0436
Mailing address
1940 ENCHANTED WAY STE 103A, PO BOX 277, GRAPEVINE, TX 76051-0965
(214) 226-2973
(800) 874-4085
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
29811
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2151327
PK
—
Enumeration date
04/02/2015
Last updated
06/21/2016
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