Provider Demographics
NPI:1184128258
Name:PHARMACY DELIVERY
Entity type:Organization
Organization Name:PHARMACY DELIVERY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MAHMOUD
Authorized Official - Middle Name:
Authorized Official - Last Name:ABUAZAB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-573-6336
Mailing Address - Street 1:333 N SHILOH RD
Mailing Address - Street 2:STE 109
Mailing Address - City:GARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:75042-6680
Mailing Address - Country:US
Mailing Address - Phone:469-573-6336
Mailing Address - Fax:469-573-5115
Practice Address - Street 1:333 N SHILOH RD
Practice Address - Street 2:STE 109
Practice Address - City:GARLAND
Practice Address - State:TX
Practice Address - Zip Code:75042-6680
Practice Address - Country:US
Practice Address - Phone:469-573-6336
Practice Address - Fax:469-573-5115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-03-22
Last Update Date:2018-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX318323336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2175819OtherPK