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Organization

GROVE MEDICAL CENTER PHARMACY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOHN DE LANGE (PHARMACIST)
(214) 391-2414
Entity
Organization

Contact information

Practice address
1143 S BUCKNER BLVD, DALLAS, TX 75217-4304
(214) 391-2414
(214) 391-0832
Mailing address
1143 S BUCKNER BLVD, DALLAS, TX 75217-4304
(214) 391-2414
(214) 391-0832

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
13464
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
143571
TX
Enumeration date
12/15/2006
Last updated
03/10/2020
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