MEDICARE: TAKEDA ONCOLOGY HERE2ASSIST

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	36087	OTHER	TX	PHARMACY

General Provider Information

NPI Number	:	1063368777
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TAKEDA ONCOLOGY HERE2ASSIST

Provider Business Mailing Address
First Line	:	2730 EDMONDS LN # 400D
Second Line	:
City	:	LEWISVILLE
State	:	TX
Zip	:	75067-6731
Country	:	US
Telephone Number	:	844-817-6468
Fax Number	:	844-269-3038

Provider Business Practice Location Address
First Line	:	2730 EDMONDS LN # 400D
Second Line	:
City	:	LEWISVILLE
State	:	TX
Zip	:	75067-6731
Country	:	US
Telephone Number	:	844-817-6468
Fax Number	:	844-269-3038

Authorized Official
Title or Position	:	DIRECTOR
Name	:	JONATHAN KWIATKOWSKI
Credential	:	RPH
Telephone Number	:	214-502-7015

Provider Enumeration Date	:	03/05/2026
Last Update Date	:	03/05/2026

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