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General NPI Number Information
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NPI Number | 1982920419
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Entity Type | Organization
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Legal Business Name | FIVE STAR PHARMACY SERVICES LLC
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Dates
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Enumeration Date | 04/08/2010
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Last Update Date | 04/06/2011
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Provider Practice Location Address
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Address Line | 14800 LANDMARK BLVD SUITE 250
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City | DALLAS
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State | TX
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Zip | 75254-7565
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Country | US
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Telephone | 214-237-4510
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Fax | 214-303-1899
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Provider Business Mailing Address
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Address Line | 14800 LANDMARK BLVD SUITE 250
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City | DALLAS
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State | TX
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Zip | 75254-7565
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Country | US
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Telephone | 214-237-4510
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Fax | 214-303-1899
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Authorized Official
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Title or Position | PIC
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Name | JOHN HENRY MCKEE
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Credential | P.PH.
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Telephone | 214-679-3537
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 26671
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License Number State | TX
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