MEDICARE: DALLAS COUNTY HOSPITAL DISTRICT

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	332B00000X	Durable Medical Equipment & Medical Supplies
3	3336C0002X	Clinic Pharmacy	16947	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2105553	OTHER		PK
2	16947	OTHER	TX	LICENSE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1396876298
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DALLAS COUNTY HOSPITAL DISTRICT

Provider Business Mailing Address
First Line	:	5200 HARRY HINES BLVD
Second Line	:	PHARMACY ADMINISTRATION
City	:	DALLAS
State	:	TX
Zip	:	75235-7709
Country	:	US
Telephone Number	:	214-590-8714
Fax Number	:	469-419-3023

Provider Business Practice Location Address
First Line	:	802 HOPKINS ST
Second Line	:
City	:	GARLAND
State	:	TX
Zip	:	75040-7379
Country	:	US
Telephone Number	:	214-266-0662
Fax Number	:	214-266-0748

Authorized Official
Title or Position	:	EVP & COO
Name	:	EDMUNDO CASTANEDA
Credential	:
Telephone Number	:	214-590-8006

Provider Enumeration Date	:	03/09/2007
Last Update Date	:	01/28/2026

Similar Medicare Providers

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Practice Location Address:

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Directions to “DALLAS COUNTY HOSPITAL DISTRICT ” Practice Location

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