Provider Demographics
NPI:1578830360
Name:REMINGTON HERITAGE HOLDINGS INC
Entity Type:Organization
Organization Name:REMINGTON HERITAGE HOLDINGS INC
Other - Org Name:TOTAL PHARMACY ENNIS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROTIMI
Authorized Official - Middle Name:
Authorized Official - Last Name:AKHIGBE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:972-276-7071
Mailing Address - Street 1:329 N SHILOH RD STE B
Mailing Address - Street 2:
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75042-6610
Mailing Address - Country:US
Mailing Address - Phone:972-276-7071
Mailing Address - Fax:972-276-7074
Practice Address - Street 1:329 N SHILOH RD STE B
Practice Address - Street 2:
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042-6610
Practice Address - Country:US
Practice Address - Phone:972-276-7071
Practice Address - Fax:972-276-7074
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-21
Last Update Date:2022-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X
TX277643336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2132769OtherPK
TX146479Medicaid
TX148656Medicaid
TX146799Medicaid