Provider Demographics
NPI:1740751759
Name:WYNDHAM PHARMACY INC
Entity Type:Organization
Organization Name:WYNDHAM PHARMACY INC
Other - Org Name:WYNDHAM RX CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACY MANAGER (PIC)
Authorized Official - Prefix:
Authorized Official - First Name:TUYEN
Authorized Official - Middle Name:JENNY
Authorized Official - Last Name:VO
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:682-270-8779
Mailing Address - Street 1:903 MEDICAL CENTRE DR STE C
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76012-4754
Mailing Address - Country:US
Mailing Address - Phone:682-270-8779
Mailing Address - Fax:682-238-0748
Practice Address - Street 1:903 MEDICAL CENTRE DR STE C
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76012-4754
Practice Address - Country:US
Practice Address - Phone:682-270-8779
Practice Address - Fax:682-238-0748
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-17
Last Update Date:2019-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy