Provider Demographics
NPI:1437403227
Name:DASHWOOD PHARMACY
Entity Type:Organization
Organization Name:DASHWOOD PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:RAVI
Authorized Official - Middle Name:
Authorized Official - Last Name:MORISETTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:646-641-1193
Mailing Address - Street 1:1300 W. WALNUT HILL LANE
Mailing Address - Street 2:SUITE 163
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75038
Mailing Address - Country:US
Mailing Address - Phone:972-756-0915
Mailing Address - Fax:972-756-0789
Practice Address - Street 1:1300 W. WALNUT HILL LANE
Practice Address - Street 2:SUITE 163
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75038
Practice Address - Country:US
Practice Address - Phone:972-756-0915
Practice Address - Fax:972-756-0789
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-11-01
Last Update Date:2015-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy