MEDICARE: PARKWOOD PHARMACY

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	28125	TX

General Provider Information

NPI Number	:	1306195615
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PARKWOOD PHARMACY

Provider Business Mailing Address
First Line	:	3415 S COOPER ST STE 106
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76015-3434
Country	:	US
Telephone Number	:	817-642-5613
Fax Number	:

Provider Business Practice Location Address
First Line	:	3415 S COOPER ST STE 106
Second Line	:
City	:	ARLINGTON
State	:	TX
Zip	:	76015-3434
Country	:	US
Telephone Number	:	817-642-5613
Fax Number	:

Authorized Official
Title or Position	:	OFFICER
Name	:	MR. THAI PHAM
Credential	:	OFFICER
Telephone Number	:	817-642-5613

Provider Enumeration Date	:	08/31/2012
Last Update Date	:	01/06/2017

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Directions to “PARKWOOD PHARMACY ” Practice Location

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