Provider Demographics
NPI:1619128402
Name:REMINGTON HERITAGE INC
Entity Type:Organization
Organization Name:REMINGTON HERITAGE INC
Other - Org Name:TOTAL PHARMACY II
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PIC
Authorized Official - Prefix:
Authorized Official - First Name:KUNLE
Authorized Official - Middle Name:
Authorized Official - Last Name:TOMETI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-294-9552
Mailing Address - Street 1:4323 N JOSEY LN
Mailing Address - Street 2:STE 102
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75010-4633
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4323 N JOSEY LN
Practice Address - Street 2:STE 102
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75010-4633
Practice Address - Country:US
Practice Address - Phone:972-395-3100
Practice Address - Fax:972-395-3103
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-10
Last Update Date:2008-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 3336C0004X
TX262053336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4550047OtherNCPDP PROVIDER IDENTIFICATION NUMBER