Provider Demographics
NPI:1639590995
Name:AGATENO TECHNOLOGIES LLC
Entity Type:Organization
Organization Name:AGATENO TECHNOLOGIES LLC
Other - Org Name:EXPRESS CARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:SHINU
Authorized Official - Middle Name:
Authorized Official - Last Name:PUNNOOSE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-800-5526
Mailing Address - Street 1:3648 OLD DENTON RD STE 104
Mailing Address - Street 2:
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75007-7977
Mailing Address - Country:US
Mailing Address - Phone:214-800-5526
Mailing Address - Fax:214-329-1203
Practice Address - Street 1:3648 OLD DENTON RD STE 104
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-7977
Practice Address - Country:US
Practice Address - Phone:214-800-5526
Practice Address - Fax:214-329-1203
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-01-03
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX289473336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy