Provider Demographics
NPI:1942242391
Name:SENIOR PHARMACY SERVICES, INC.
Entity Type:Organization
Organization Name:SENIOR PHARMACY SERVICES, INC.
Other - Org Name:TRINITY APOTHECARY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE ADMINISTRATOR/AR
Authorized Official - Prefix:
Authorized Official - First Name:ERIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:GALLARDO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-492-8841
Mailing Address - Street 1:2501 E HEBRON PKWY
Mailing Address - Street 2:SUITE 100B
Mailing Address - City:CARROLLTON
Mailing Address - State:TX
Mailing Address - Zip Code:75010
Mailing Address - Country:US
Mailing Address - Phone:972-492-8841
Mailing Address - Fax:972-300-3640
Practice Address - Street 1:2501 E HEBRON PKWY
Practice Address - Street 2:STE 100B
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75010
Practice Address - Country:US
Practice Address - Phone:972-492-2151
Practice Address - Fax:972-492-6437
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-11
Last Update Date:2021-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 3336H0001X, 3336L0003X, 3336S0011X
TX31439333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4568739OtherOTHER ID NUMBER-COMMERCIAL NUMBER
TX144940Medicaid
0964020002Medicare NSC