Provider Demographics
NPI:1134110646
Name:C AND I INTERNATIONAL INC
Entity Type:Organization
Organization Name:C AND I INTERNATIONAL INC
Other - Org Name:PRESTON VILLAGE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:CHINEDUM
Authorized Official - Middle Name:
Authorized Official - Last Name:EGUZOUWA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-437-5408
Mailing Address - Street 1:12606 GREENVILLE AVE # 175
Mailing Address - Street 2:NORTHPOINT MEDICAL ARTS BLDG
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-1921
Mailing Address - Country:US
Mailing Address - Phone:972-866-0017
Mailing Address - Fax:972-866-0019
Practice Address - Street 1:12606 GREENVILLE AVE # 175
Practice Address - Street 2:NORTHPOINT MEDICAL ARTS BLDG
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-1921
Practice Address - Country:US
Practice Address - Phone:972-866-0017
Practice Address - Fax:972-866-0019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-11-03
Last Update Date:2016-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX29803333600000X
3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes333600000XSuppliersPharmacyGroup - Multi-Specialty
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2158048OtherPK
TX145506Medicaid
2158048OtherPK