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General NPI Number Information
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NPI Number | 1811323447
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Entity Type | Organization
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Legal Business Name | COR PHARMA, LLC
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Dates
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Enumeration Date | 09/14/2013
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Last Update Date | 09/14/2013
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Provider Practice Location Address
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Address Line | 5710 LBJ FWY # 140
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City | DALLAS
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State | TX
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Zip | 75240-6324
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Country | US
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Telephone | 877-207-3858
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Fax | 888-330-8711
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Provider Business Mailing Address
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Address Line | 5710 LBJ FWY # 140
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City | DALLAS
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State | TX
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Zip | 75240-6324
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Country | US
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Telephone | 877-207-3858
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Fax | 888-330-8711
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | MR. JACK DEAR III
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Credential |
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Telephone | 877-207-3858
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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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