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General NPI Number Information
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NPI Number | 1023611340
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Entity Type | Organization
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Legal Business Name | I CARE NETWORK CONSULTANTS, LLC
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Dates
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Enumeration Date | 11/19/2020
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Last Update Date | 11/19/2020
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Provider Practice Location Address
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Address Line | 6201 MATLOCK RD STE 125
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City | ARLINGTON
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State | TX
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Zip | 76002-2763
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Country | US
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Telephone | 214-210-9969
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Fax | 214-574-9344
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Provider Business Mailing Address
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Address Line | 329 WATER CREST DR
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City | DESOTO
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State | TX
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Zip | 75115-3893
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Country | US
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Telephone | 214-893-0885
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Fax | 214-574-9344
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Authorized Official
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Title or Position | PHARMACIST/MANAGER
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Name | SHIRLEY DIANN THOMAS
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Credential | R.PH.
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Telephone | 817-538-5534
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 332900000X
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Taxonomy Name | Non-Pharmacy Dispensing Site
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License Number |
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License Number State |
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