Provider Demographics
NPI:1467978767
Name:ENTERPRISE PHARMACY NETWORK,LLC
Entity Type:Organization
Organization Name:ENTERPRISE PHARMACY NETWORK,LLC
Other - Org Name:DISCOUNT MEDS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:DALLAS
Authorized Official - Middle Name:BENTON
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:346-304-2909
Mailing Address - Street 1:802 TEXAS PKWY STE 2A
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-6400
Mailing Address - Country:US
Mailing Address - Phone:346-304-2909
Mailing Address - Fax:346-304-2909
Practice Address - Street 1:802 TEXAS PKWY STE 2A
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-6400
Practice Address - Country:US
Practice Address - Phone:346-304-2909
Practice Address - Fax:346-304-2909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX315193336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy