MEDICARE: GALAXY PHARMA INC

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		TX

General Provider Information

NPI Number	:	1881994051
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GALAXY PHARMA INC

Provider Business Mailing Address
First Line	:	9501 CLIFFORD ST STE E
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76108-4460
Country	:	US
Telephone Number	:	817-246-6600
Fax Number	:	817-246-6700

Provider Business Practice Location Address
First Line	:	9501 CLIFFORD ST STE E
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76108-4460
Country	:	US
Telephone Number	:	817-246-6600
Fax Number	:	817-246-6700

Authorized Official
Title or Position	:	SECRETARY
Name	:	PRAFUL D PATEL
Credential	:
Telephone Number	:	214-457-5571

Provider Enumeration Date	:	10/21/2010
Last Update Date	:	10/21/2010

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Directions to “GALAXY PHARMA INC ” Practice Location

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