Provider Demographics
NPI:1376225730
Name:PALMER PHARMACY PLUS INC
Entity Type:Organization
Organization Name:PALMER PHARMACY PLUS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF OPERATING OFFIER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HUGHEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-951-0133
Mailing Address - Street 1:1341 W MOCKINGBIRD LN STE 500W
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75247-6903
Mailing Address - Country:US
Mailing Address - Phone:214-518-9908
Mailing Address - Fax:
Practice Address - Street 1:2731 W NORTHWEST HWY STE 105
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75220-4782
Practice Address - Country:US
Practice Address - Phone:214-765-9238
Practice Address - Fax:214-765-9240
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-04
Last Update Date:2023-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX145097Medicaid