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General NPI Number Information
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NPI Number | 1881105724
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Entity Type | Organization
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Legal Business Name | RIDGEWOOD PHARMACY LLC
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Dates
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Enumeration Date | 10/18/2017
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Last Update Date | 10/18/2017
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Provider Practice Location Address
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Address Line | 119 W KINGSLEY RD STE 122
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City | GARLAND
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State | TX
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Zip | 75041-3432
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Country | US
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Telephone | 469-814-0218
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Fax |
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Provider Business Mailing Address
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Address Line | 119 W KINGSLEY RD STE 122
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City | GARLAND
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State | TX
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Zip | 75041-3432
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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 | PIC/OWNER
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Name | MR. NARESH VAGDIYA
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Credential | PHARMACIST
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Telephone | 469-814-0218
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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 | 31657
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License Number State | TX
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