Provider Demographics
NPI:1295831337
Name:NATIONAL HEALTH CARE PHARMACY, L.L.C.
Entity Type:Organization
Organization Name:NATIONAL HEALTH CARE PHARMACY, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PIC/PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:D
Authorized Official - Last Name:ATER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:817-492-9101
Mailing Address - Street 1:6701 RANDOL MILL RD
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76112-1255
Mailing Address - Country:US
Mailing Address - Phone:817-492-9101
Mailing Address - Fax:682-225-8009
Practice Address - Street 1:6701 RANDOL MILL RD
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76112-1255
Practice Address - Country:US
Practice Address - Phone:817-492-9101
Practice Address - Fax:682-225-8009
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX233423336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4502490OtherNCPDP
TX145455Medicaid
TX145455Medicaid