Provider Demographics
NPI:1043399447
Name:GENERX DISCOUNT PHARMACY INC.
Entity Type:Organization
Organization Name:GENERX DISCOUNT PHARMACY INC.
Other - Org Name:GENERX DISCOUNT PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:DOROTHY
Authorized Official - Middle Name:A
Authorized Official - Last Name:NWOSU
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:972-417-8895
Mailing Address - Street 1:1235 S JOSEY LN STE 533
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75006-7665
Mailing Address - Country:US
Mailing Address - Phone:972-417-8895
Mailing Address - Fax:972-418-1616
Practice Address - Street 1:1235 S JOSEY LN STE 533
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75006-7665
Practice Address - Country:US
Practice Address - Phone:972-417-8895
Practice Address - Fax:972-418-1616
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-04
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX148364Medicaid