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General NPI Number Information
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NPI Number | 1124430202
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Entity Type | Organization
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Legal Business Name | POPHARMACY LLC
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Dates
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Enumeration Date | 05/23/2014
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 17300 DALLAS PKWY SUITE 1080A
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City | DALLAS
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State | TX
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Zip | 75248-1145
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Country | US
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Telephone | 972-822-6292
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Fax |
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Provider Business Mailing Address
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Address Line | 2806 CLEAR SPRINGS DR
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City | PLANO
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State | TX
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Zip | 75075-7506
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Country | US
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Telephone | 972-822-6292
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. LANCE R COCHRAN
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Credential |
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Telephone | 972-822-6292
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State | TX
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