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General NPI Number Information
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NPI Number | 1639772445
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Entity Type | Organization
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Legal Business Name | BLUESTONE PHARMACY LLC
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Dates
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Enumeration Date | 11/16/2020
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Last Update Date | 05/17/2022
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Provider Practice Location Address
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Address Line | 555 REPUBLIC DR STE 108
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City | PLANO
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State | TX
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Zip | 75074-5427
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Country | US
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Telephone | 469-591-1680
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Fax |
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Provider Business Mailing Address
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Address Line | 915 W PARKER RD STE 321A
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City | PLANO
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State | TX
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Zip | 75023-7136
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | RIMA PATEL
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Credential | PHARMACIST
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Telephone | 734-658-4418
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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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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