Provider Demographics
NPI:1154497592
Name:AGAPE PHARMACY SERVICES INC.
Entity Type:Organization
Organization Name:AGAPE PHARMACY SERVICES INC.
Other - Org Name:MED-ART PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:STANLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:214-231-1300
Mailing Address - Street 1:PO BOX 451269
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75045-1269
Mailing Address - Country:US
Mailing Address - Phone:214-231-1300
Mailing Address - Fax:214-231-1303
Practice Address - Street 1:2540 N GALLOWAY AVE STE 201
Practice Address - Street 2:
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-4813
Practice Address - Country:US
Practice Address - Phone:214-231-1300
Practice Address - Fax:214-231-1303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX23000333600000X
TX332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered333600000XSuppliersPharmacy
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX145355Medicaid
TX23000OtherSTATE BOARD OF PHARMACY
TX145355Medicaid
TX23000OtherSTATE BOARD OF PHARMACY