Provider Demographics
NPI:1497363741
Name:PHARMESTATE LLC
Entity Type:Organization
Organization Name:PHARMESTATE LLC
Other - Org Name:ALLEN FAMILY DRUG
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST IN CHARGE/ CO-OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:KOMUVES
Authorized Official - Suffix:JR
Authorized Official - Credentials:R PH
Authorized Official - Phone:972-390-9888
Mailing Address - Street 1:317 CENTRAL EXPRESSWAY NORTH
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013
Mailing Address - Country:US
Mailing Address - Phone:972-390-9888
Mailing Address - Fax:972-390-9889
Practice Address - Street 1:317 CENTRAL EXPRESSWAY NORTH
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013
Practice Address - Country:US
Practice Address - Phone:972-390-9888
Practice Address - Fax:972-390-9889
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-07-22
Last Update Date:2020-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy