Provider Demographics
NPI:1710074745
Name:PARTNERS PHARMACY OF TEXAS, LLC
Entity Type:Organization
Organization Name:PARTNERS PHARMACY OF TEXAS, LLC
Other - Org Name:ADVANCED PHARMACY SERVICES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:MATTHEWS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:609-206-2664
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:908-931-7111
Mailing Address - Fax:
Practice Address - Street 1:12503 EXCHANGE DR
Practice Address - Street 2:SUITE 536
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-3699
Practice Address - Country:US
Practice Address - Phone:713-747-0656
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX300293336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX145233Medicaid
TX4520210OtherNCPDP