Provider Demographics
NPI:1003463092
Name:MEDCARE-PTX-75069 LLC
Entity Type:Organization
Organization Name:MEDCARE-PTX-75069 LLC
Other - Org Name:MEDCARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:FIZZA
Authorized Official - Middle Name:
Authorized Official - Last Name:FARID
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-313-1030
Mailing Address - Street 1:1505 HARROUN AVE STE 2
Mailing Address - Street 2:
Mailing Address - City:MCKINNEY
Mailing Address - State:TX
Mailing Address - Zip Code:75069-3433
Mailing Address - Country:US
Mailing Address - Phone:469-313-1030
Mailing Address - Fax:469-661-3925
Practice Address - Street 1:1505 HARROUN AVE STE 2
Practice Address - Street 2:
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75069-3433
Practice Address - Country:US
Practice Address - Phone:469-313-1030
Practice Address - Fax:469-661-3925
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-08-23
Last Update Date:2024-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No332BP3500XSuppliersDurable Medical Equipment & Medical SuppliesParenteral & Enteral Nutrition
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy