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General NPI Number Information
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NPI Number | 1689653040
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Entity Type | Organization
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Legal Business Name | GLENVIEW PROFESSIONAL PHARMACY INC
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Dates
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Enumeration Date | 01/13/2006
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Last Update Date | 05/01/2019
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Provider Practice Location Address
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Address Line | 7640 GLENVIEW DR STE A
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City | RICHLAND HILLS
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State | TX
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Zip | 76180-8330
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Country | US
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Telephone | 817-284-1489
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Fax | 817-284-1042
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Provider Business Mailing Address
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Address Line | 7640 GLENVIEW DR SUITE A
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City | RICHLAND HILLS
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State | TX
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Zip | 76180-8330
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Country | US
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Telephone | 817-284-1489
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Fax | 817-284-1042
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | KEITH FREAL VAN HEISE
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Credential | RPH
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Telephone | 817-284-1489
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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 | 2553
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License Number State | TX
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