Provider Demographics
NPI:1134696024
Name:EHP TEXAS LLC
Entity Type:Organization
Organization Name:EHP TEXAS LLC
Other - Org Name:PRISM HEALTH NORTH TEXAS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CHIEF PHARMACY OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:
Authorized Official - Last Name:CLARK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-572-0890
Mailing Address - Street 1:7575 HUNTINGTON PARK DR FL 2
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-5618
Mailing Address - Country:US
Mailing Address - Phone:614-572-0890
Mailing Address - Fax:855-342-0638
Practice Address - Street 1:4907 SPRING AVE STE 101
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75210-1360
Practice Address - Country:US
Practice Address - Phone:614-572-0890
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:EQUITAS HEALTH INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-10-29
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy