Provider Demographics
NPI:1750512091
Name:ALPHA PHARMACY
Entity Type:Organization
Organization Name:ALPHA PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:RAVI
Authorized Official - Middle Name:
Authorized Official - Last Name:MORISETTY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-597-9434
Mailing Address - Street 1:8787 N MACARTHUR BLVD
Mailing Address - Street 2:STE 120
Mailing Address - City:IRVING
Mailing Address - State:TX
Mailing Address - Zip Code:75063
Mailing Address - Country:US
Mailing Address - Phone:469-262-5742
Mailing Address - Fax:855-592-5742
Practice Address - Street 1:8787 N MACARTHUR BLVD
Practice Address - Street 2:STE 120
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75063
Practice Address - Country:US
Practice Address - Phone:469-262-5742
Practice Address - Fax:855-592-5742
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-04
Last Update Date:2014-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX265373336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy