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General NPI Number Information
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NPI Number | 1568718856
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Entity Type | Organization
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Legal Business Name | SENIOR CARE PHARMACY OF TEXAS LLC
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Dates
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Enumeration Date | 07/24/2012
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Last Update Date | 12/08/2016
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Provider Practice Location Address
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Address Line | 3001 SUMMIT AVE STE 200
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City | PLANO
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State | TX
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Zip | 75074-7225
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Country | US
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Telephone | 888-908-8148
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Fax | 855-209-6824
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Provider Business Mailing Address
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Address Line | 3001 SUMMIT AVE STE 200
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City | PLANO
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State | TX
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Zip | 75074-7225
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Country | US
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Telephone | 888-908-8148
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Fax | 855-209-6824
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | JASON SUTTON
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Credential | DPH
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Telephone | 888-908-8148
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 28323
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License Number State | TX
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