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General NPI Number Information
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NPI Number | 1881109734
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Entity Type | Organization
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Legal Business Name | NDC PHARMACY
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Dates
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Enumeration Date | 12/13/2017
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Last Update Date | 04/11/2019
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Provider Practice Location Address
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Address Line | 4666 MCDERMOTT RD STE 200
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City | PLANO
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State | TX
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Zip | 75024-7772
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Country | US
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Telephone | 469-888-4672
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Fax | 469-888-4672
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Provider Business Mailing Address
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Address Line | 4666 MCDERMOTT RD 200
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City | PLANO
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State | TX
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Zip | 75024
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Country | US
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Telephone | 972-517-7900
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Fax |
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | KHANH HOANG
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Credential | PHARM D
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Telephone | 469-888-4672
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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 | 31750
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License Number State | TX
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