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General NPI Number Information
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NPI Number | 1457848004
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Entity Type | Organization
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Legal Business Name | HILLCREST PHARMACY, LLC
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Dates
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Enumeration Date | 04/19/2018
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Last Update Date | 02/23/2019
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Provider Practice Location Address
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Address Line | 3065 N JOSEY LN STE 60
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City | CARROLLTON
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State | TX
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Zip | 75007-5348
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Country | US
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Telephone | 972-394-4456
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Fax | 972-394-4457
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Provider Business Mailing Address
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Address Line | 2650 FM 407 E STE 145-103
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City | BARTONVILLE
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State | TX
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Zip | 76226-7012
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Country | US
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Telephone | 225-937-4716
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Fax | 972-767-3134
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Authorized Official
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Title or Position | MANAGING MEMBER/CEO
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Name | MR. JOE PENN JR.
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Credential |
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Telephone | 972-394-4456
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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 | 802975922
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License Number State | TX
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