Healthcare Provider Details

I. General information

NPI: 1528091949
Provider Name (Legal Business Name): PHARMACY PLUS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 01/21/2023
Certification Date: 01/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

420 S DENTON TAP RD STE 110
COPPELL TX
75019-3266
US

IV. Provider business mailing address

3020 CORPORATE CT STE 300
FLOWER MOUND TX
75028-5617
US

V. Phone/Fax

Practice location:
  • Phone: 972-462-9400
  • Fax: 972-462-9600
Mailing address:
  • Phone: 972-539-3624
  • Fax: 972-539-3694

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number17136
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number17136
License Number StateTX

VIII. Authorized Official

Name: MR. THOMAS MANNING NEALE JR.
Title or Position: PRESIDENT
Credential: RPH
Phone: 972-539-3624