Provider Demographics
NPI:1114442522
Name:VISTA SPECIALTY, LLC
Entity Type:Organization
Organization Name:VISTA SPECIALTY, LLC
Other - Org Name:VISTA SPECIALTY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF IMPLEMENTATION/PHARMACY
Authorized Official - Prefix:MR
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:MCELFRESH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-795-0262
Mailing Address - Street 1:600 METHODIST ST.
Mailing Address - Street 2:SUITE 1120
Mailing Address - City:RED OAK
Mailing Address - State:TX
Mailing Address - Zip Code:75154
Mailing Address - Country:US
Mailing Address - Phone:281-888-9403
Mailing Address - Fax:832-767-2704
Practice Address - Street 1:600 METHODIST ST.
Practice Address - Street 2:SUITE 1120
Practice Address - City:RED OAK
Practice Address - State:TX
Practice Address - Zip Code:75154
Practice Address - Country:US
Practice Address - Phone:281-888-9403
Practice Address - Fax:832-767-2704
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-07
Last Update Date:2019-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX315443336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy