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General NPI Number Information
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NPI Number | 1588079594
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Entity Type | Organization
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Legal Business Name | EL DORADO PHARMACY LLC
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Dates
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Enumeration Date | 06/27/2014
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Last Update Date | 03/14/2017
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Provider Practice Location Address
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Address Line | 1300 E ARAPAHO RD STE 210
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City | RICHARDSON
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State | TX
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Zip | 75081-2445
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Country | US
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Telephone | 214-329-4580
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Fax | 214-329-4599
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Provider Business Mailing Address
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Address Line | 1300 E ARAPAHO RD SUITE 210
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City | RICHARDSON
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State | TX
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Zip | 75081-2456
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Country | US
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Telephone | 214-329-4580
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Fax | 214-329-4599
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Authorized Official
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Title or Position | OWNER
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Name | JOSHUA MCCOOEY
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Credential |
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Telephone | 214-329-4562
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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 | 29317
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License Number State | TX
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