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General NPI Number Information
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NPI Number | 1699846212
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Entity Type | Organization
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Legal Business Name | PARKSIDE PHARMACY
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Dates
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Enumeration Date | 11/13/2006
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Last Update Date | 05/19/2015
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Provider Practice Location Address
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Address Line | 6449 COIT RD STE 116
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City | FRISCO
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State | TX
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Zip | 75035-8670
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Country | US
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Telephone | 972-712-0649
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Fax | 972-712-0644
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Provider Business Mailing Address
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Address Line | 6449 COIT RD STE 116
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City | FRISCO
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State | TX
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Zip | 75035-8670
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Country | US
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Telephone | 972-712-0649
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Fax | 972-712-0644
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Authorized Official
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Title or Position | DIRECTOR
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Name | COURTNEY CAPPS
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Credential |
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Telephone | 972-712-0649
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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 | 29491
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License Number State | TX
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