MEDICARE: PHARMACY CONCEPTS LTD

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	3336C0003X	Community/Retail Pharmacy
2	333600000X	Pharmacy
3	3336L0003X	Long Term Care Pharmacy	20093	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2093380	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1164433751
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PHARMACY CONCEPTS LTD

Provider Business Mailing Address
First Line	:	610 MAGIC MILE ST
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76011-5108
Country	:	US
Telephone Number	:	817-633-6688
Fax Number	:	817-633-6678

Provider Business Practice Location Address
First Line	:	610 MAGIC MILE ST
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76011-5108
Country	:	US
Telephone Number	:	817-633-6688
Fax Number	:	817-633-6678

Authorized Official
Title or Position	:	OWNER
Name	:	KEITH TAYLOR
Credential	:	RPH
Telephone Number	:	817-633-6688

Provider Enumeration Date	:	08/10/2006
Last Update Date	:	11/01/2016

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Directions to “PHARMACY CONCEPTS LTD ” Practice Location

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