Healthcare Provider Details

I. General information

NPI: 1063681013
Provider Name (Legal Business Name): POIROT PHARMACY SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2008
Last Update Date: 02/25/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4537 WESTWAY AVE
DALLAS TX
75205-3632
US

IV. Provider business mailing address

4537 WESTWAY AVE
DALLAS TX
75205-3632
US

V. Phone/Fax

Practice location:
  • Phone: 214-252-1984
  • Fax:
Mailing address:
  • Phone: 214-252-1984
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number27891
License Number StateTX

VIII. Authorized Official

Name: JACKIE FELTS POIROT
Title or Position: OWNER
Credential: R.PH.
Phone: 214-252-1984