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General NPI Number Information
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NPI Number | 1619356656
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Entity Type | Organization
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Legal Business Name | AC PHARMACY, LLC
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Dates
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Enumeration Date | 05/22/2015
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Last Update Date | 07/14/2015
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Provider Practice Location Address
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Address Line | 9090 SKILLMAN ST SUITE 180A
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City | DALLAS
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State | TX
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Zip | 75243-8259
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Country | US
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Telephone | 214-221-0353
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Fax | 214-221-0504
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Provider Business Mailing Address
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Address Line | PO BOX 741414
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City | DALLAS
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State | TX
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Zip | 75374-1414
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Country | US
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Telephone | 214-221-0353
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Fax | 214-221-0504
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | MR. ANTHONY C MADUBUIKE
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Credential | R.PH
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Telephone | 214-868-8907
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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 | 29993
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License Number State | TX
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