=====================================================
General NPI Number Information
=====================================================
NPI Number | 1902722978
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | UPTOWN SPECIALTY PHARMACY LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/25/2026
-----------------------------------------------------
Last Update Date | 06/25/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 131 DEGAN AVE STE 103D
-----------------------------------------------------
City | LEWISVILLE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75057-3664
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 214-989-3629
-----------------------------------------------------
Fax | 972-947-5294
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 131 DEGAN AVE STE 103D
-----------------------------------------------------
City | LEWISVILLE
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 75057-3664
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 214-989-3629
-----------------------------------------------------
Fax | 972-947-5294
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | AFAM NWANGWU
-----------------------------------------------------
Credential | PHARM D
-----------------------------------------------------
Telephone | 817-899-5520
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336M0002X
-----------------------------------------------------
Taxonomy Name | Mail Order Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 3336S0011X
-----------------------------------------------------
Taxonomy Name | Specialty Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #3
-----------------------------------------------------
Taxonomy Code | 3336L0003X
-----------------------------------------------------
Taxonomy Name | Long Term Care Pharmacy
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------