Provider Demographics
NPI:1003223041
Name:FOREST HILL PHARMACY INC
Entity Type:Organization
Organization Name:FOREST HILL PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KWABENA
Authorized Official - Middle Name:
Authorized Official - Last Name:BONSU
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM-D
Authorized Official - Phone:817-887-9434
Mailing Address - Street 1:3403 MANSFIELD HWY
Mailing Address - Street 2:
Mailing Address - City:FOREST HILL
Mailing Address - State:TX
Mailing Address - Zip Code:76119-6027
Mailing Address - Country:US
Mailing Address - Phone:817-887-9434
Mailing Address - Fax:817-887-9436
Practice Address - Street 1:3403 MANSFIELD HWY
Practice Address - Street 2:
Practice Address - City:FOREST HILL
Practice Address - State:TX
Practice Address - Zip Code:76119-6027
Practice Address - Country:US
Practice Address - Phone:817-887-9434
Practice Address - Fax:817-887-9436
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-07-22
Last Update Date:2015-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX29368302R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302R00000XManaged Care OrganizationsHealth Maintenance Organization