Provider Demographics
NPI:1477685576
Name:ARAPAHO PHARMACY
Entity Type:Organization
Organization Name:ARAPAHO PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:MR
Authorized Official - First Name:ORVILLE
Authorized Official - Middle Name:W
Authorized Official - Last Name:WEISS
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:972-235-7133
Mailing Address - Street 1:819 W ARAPAHO RD STE 57
Mailing Address - Street 2:
Mailing Address - City:RICHARDSON
Mailing Address - State:TX
Mailing Address - Zip Code:75080-5038
Mailing Address - Country:US
Mailing Address - Phone:972-235-7133
Mailing Address - Fax:972-235-6968
Practice Address - Street 1:819 W ARAPAHO RD STE 57
Practice Address - Street 2:
Practice Address - City:RICHARDSON
Practice Address - State:TX
Practice Address - Zip Code:75080-5038
Practice Address - Country:US
Practice Address - Phone:972-235-7133
Practice Address - Fax:972-235-6968
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2008-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX02255333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX141088Medicaid