Provider Demographics
NPI:1225343999
Name:COR PHARMA LLC
Entity Type:Organization
Organization Name:COR PHARMA LLC
Other - Org Name:ROC PHARMA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRIS
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMDON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-432-6550
Mailing Address - Street 1:5710 LBJ FWY
Mailing Address - Street 2:SUITE 325
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75240-6324
Mailing Address - Country:US
Mailing Address - Phone:972-432-6550
Mailing Address - Fax:214-261-2217
Practice Address - Street 1:5710 LBJ FWY
Practice Address - Street 2:STE 481
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75240-6324
Practice Address - Country:US
Practice Address - Phone:214-888-8090
Practice Address - Fax:888-887-1120
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-18
Last Update Date:2015-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX291533336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2147384OtherPK
2126337OtherPK