Provider Demographics
NPI:1639434848
Name:P&M PHARMA CORPORATION
Entity Type:Organization
Organization Name:P&M PHARMA CORPORATION
Other - Org Name:GEESONS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MANISH
Authorized Official - Middle Name:
Authorized Official - Last Name:DESAI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-636-3485
Mailing Address - Street 1:5201 S COOPER ST
Mailing Address - Street 2:STE 117
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76017-5933
Mailing Address - Country:US
Mailing Address - Phone:817-419-2688
Mailing Address - Fax:817-419-2690
Practice Address - Street 1:5201 S COOPER ST
Practice Address - Street 2:STE 117
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76017-5933
Practice Address - Country:US
Practice Address - Phone:817-419-2688
Practice Address - Fax:817-419-2690
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-13
Last Update Date:2016-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX301383336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail PharmacyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
2155677OtherPK