MEDICARE: CHEBYCARE PHARMACY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	3336C0004X	Compounding Pharmacy
2	3336C0003X	Community/Retail Pharmacy	28141	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5906447	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number	:	1568718609
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHEBYCARE PHARMACY

Provider Business Mailing Address
First Line	:	1421 W BUCKINGHAM RD
Second Line	:
City	:	GARLAND
State	:	TX
Zip	:	75042-4202
Country	:	US
Telephone Number	:	972-675-1100
Fax Number	:	972-675-1105

Provider Business Practice Location Address
First Line	:	1421 W BUCKINGHAM RD
Second Line	:
City	:	GARLAND
State	:	TX
Zip	:	75042-4202
Country	:	US
Telephone Number	:	972-675-1100
Fax Number	:	972-675-1105

Authorized Official
Title or Position	:	PIC
Name	:	CONSTANCE ECHEBIRI
Credential	:
Telephone Number	:	972-675-1100

Provider Enumeration Date	:	07/26/2012
Last Update Date	:	01/16/2026

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Directions to “CHEBYCARE PHARMACY ” Practice Location

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