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General NPI Number Information
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NPI Number | 1033201702
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Entity Type | Organization
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Legal Business Name | GILLEY'S PHARMACY, INC
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Dates
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Enumeration Date | 09/29/2006
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Last Update Date | 08/01/2008
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Provider Practice Location Address
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Address Line | 2600 W JEFFERSON 227
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City | DALLAS
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State | TX
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Zip | 75211
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Country | US
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Telephone | 214-946-5111
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Fax | 214-946-1113
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Provider Business Mailing Address
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Address Line | 2600 W JEFFERSON 227
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City | DALLAS
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State | TX
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Zip | 75211
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Country | US
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Telephone | 214-946-5111
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Fax | 214-946-1113
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Authorized Official
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Title or Position | PRES
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Name | MR. JAMES ROY GILLEY
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Credential | RPH
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Telephone | 214-946-5111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 00174
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License Number State | TX
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