Provider Demographics
NPI:1700818028
Name:PHARMACY PLUS, INC.
Entity Type:Organization
Organization Name:PHARMACY PLUS, INC.
Other - Org Name:PHARMACY PLUS #2
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:MANNING
Authorized Official - Last Name:NEALE
Authorized Official - Suffix:SR
Authorized Official - Credentials:RPH
Authorized Official - Phone:469-635-2849
Mailing Address - Street 1:2901 CORPORATE CIR
Mailing Address - Street 2:STE 100
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-5625
Mailing Address - Country:US
Mailing Address - Phone:254-739-2526
Mailing Address - Fax:254-739-2528
Practice Address - Street 1:209 N ELLIS ST
Practice Address - Street 2:
Practice Address - City:GROESBECK
Practice Address - State:TX
Practice Address - Zip Code:76642-1310
Practice Address - Country:US
Practice Address - Phone:254-729-3375
Practice Address - Fax:254-729-5037
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2011-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX10039332B00000X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX143345Medicaid
TX4521426OtherNCPDP #
TX143345Medicaid