Provider Demographics
NPI:1881193282
Name:FOTOK ENTERPRISES
Entity Type:Organization
Organization Name:FOTOK ENTERPRISES
Other - Org Name:KAREPLUS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:JIMI
Authorized Official - Middle Name:
Authorized Official - Last Name:KLEMENTI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-771-3151
Mailing Address - Street 1:701 S STEMMONS FWY
Mailing Address - Street 2:SUITE #230
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-4547
Mailing Address - Country:US
Mailing Address - Phone:469-771-3151
Mailing Address - Fax:469-771-3152
Practice Address - Street 1:701 S STEMMONS FWY STE 230
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-4519
Practice Address - Country:US
Practice Address - Phone:469-771-3151
Practice Address - Fax:469-771-3152
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-12
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
TX318593336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX149765Medicaid