Provider Demographics
NPI:1619342698
Name:REMEDI SENIORCARE OF DALLAS, LLC
Entity Type:Organization
Organization Name:REMEDI SENIORCARE OF DALLAS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:GOULD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:614-956-2417
Mailing Address - Street 1:1 OLYMPIC PL
Mailing Address - Street 2:SUITE 600
Mailing Address - City:TOWSON
Mailing Address - State:MD
Mailing Address - Zip Code:21204-4104
Mailing Address - Country:US
Mailing Address - Phone:443-730-8957
Mailing Address - Fax:410-484-6021
Practice Address - Street 1:2700 RESEARCH DR
Practice Address - Street 2:SUITE 200
Practice Address - City:PLANO
Practice Address - State:TX
Practice Address - Zip Code:75074-8340
Practice Address - Country:US
Practice Address - Phone:443-730-8957
Practice Address - Fax:410-484-6021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-02
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy