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General NPI Number Information
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NPI Number | 1699173849
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Entity Type | Organization
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Legal Business Name | CARECHOICE PHARMACY LLC
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Dates
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Enumeration Date | 12/19/2014
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 813 N JUPITER RD
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City | GARLAND
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State | TX
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Zip | 75042-5439
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Country | US
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Telephone | 469-909-6430
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Fax | 469-277-3922
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Provider Business Mailing Address
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Address Line | 813 N JUPITER RD
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City | GARLAND
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State | TX
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Zip | 75042-5439
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Country | US
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Telephone | 469-909-6430
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Fax | 469-277-3922
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | HUNG LAI
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Credential | PHARMD
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Telephone | 469-909-6430
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 47960
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 30060
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License Number State | TX
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