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NPI Code Detail

MEDICARE: LEGACY HEIGHTS PHARMACY LLC

MEDICARE: LEGACY HEIGHTS PHARMACY LLC
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
13336C0003XCommunity/Retail Pharmacy

General Provider Information

NPI Number : 1801353818
Entity Type Code : Organization
Provider Name (Legal Business Name) : LEGACY HEIGHTS PHARMACY LLC
Provider Business Mailing Address
First Line : 617 E 16TH ST
Second Line : NORTH SUITE
City : PLANO
State : TX
Zip : 75074-5726
Country : US
Telephone Number : 972-204-5855
Fax Number : 972-525-5451
Provider Business Practice Location Address
First Line : 617 E 16TH ST
Second Line :
City : PLANO
State : TX
Zip : 75074-5726
Country : US
Telephone Number : 972-204-5855
Fax Number : 972-525-5451
Authorized Official
Title or Position : MANAGER
Name : JOEL SPEERS
Credential :
Telephone Number : 469-396-8059
Provider Enumeration Date : 02/26/2019
Last Update Date : 12/16/2019

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Directions to “LEGACY HEIGHTS PHARMACY LLC ” Practice Location

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