Provider Demographics
NPI:1619230976
Name:PARTNERS PHARMACY OF TEXAS, LLC
Entity Type:Organization
Organization Name:PARTNERS PHARMACY OF TEXAS, LLC
Other - Org Name:ADVANCED PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF FINANCE/CONTROLLER
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:TOOHEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:908-931-9111
Mailing Address - Street 1:50 LAWRENCE RD
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07081-3121
Mailing Address - Country:US
Mailing Address - Phone:908-931-9111
Mailing Address - Fax:908-931-9328
Practice Address - Street 1:2360 CRIST RD
Practice Address - Street 2:SUITE 1400
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75040-3715
Practice Address - Country:US
Practice Address - Phone:908-931-9111
Practice Address - Fax:908-931-9328
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-21
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336C0004X
TX301373336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5906156OtherNCPDP PROVIDER IDENTIFICATION NUMBER