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General NPI Number Information
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NPI Number | 1255766952
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Entity Type | Organization
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Legal Business Name | NEW CARE PHARMACY, INC.
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Dates
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Enumeration Date | 09/12/2013
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Last Update Date | 09/18/2013
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Provider Practice Location Address
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Address Line | 900 JEROME STREET SUITE 100
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City | FORT WORTH
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State | TX
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Zip | 76104
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Country | US
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Telephone | 817-924-7000
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Fax | 817-924-7007
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Provider Business Mailing Address
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Address Line | 900 JEROME STREET SUITE 100
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City | FORT WORTH
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State | TX
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Zip | 76104
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Country | US
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Telephone | 817-924-7000
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Fax | 817-924-7007
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Authorized Official
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Title or Position | OWNER/PHARMACIST-IN-CHARGE
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Name | DR. OLUFUNKE JAIYEOLA
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Credential | PHARM.D.; M.B.A.
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Telephone | 214-418-4097
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 28785
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License Number State | TX
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