Provider Demographics
NPI:1336375591
Name:APPLE DRUGS #102
Entity Type:Organization
Organization Name:APPLE DRUGS #102
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:OJIMMADU
Authorized Official - Last Name:ANUGWOM
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:972-270-0041
Mailing Address - Street 1:1900 OATES DR
Mailing Address - Street 2:SUITE 138
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-6862
Mailing Address - Country:US
Mailing Address - Phone:972-270-0041
Mailing Address - Fax:
Practice Address - Street 1:1900 OATES DR
Practice Address - Street 2:SUITE 138
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-6862
Practice Address - Country:US
Practice Address - Phone:972-270-0041
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:APPLE DRUGS, PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2009-06-02
Last Update Date:2010-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX26472333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy