Provider Demographics
NPI:1336615947
Name:ALLEN PHARMACY & WELLNESS, LLC
Entity Type:Organization
Organization Name:ALLEN PHARMACY & WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER/ PHARMACIST-IN-CHARGE
Authorized Official - Prefix:DR
Authorized Official - First Name:DEEPA
Authorized Official - Middle Name:PRANAY
Authorized Official - Last Name:PATTANI
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:972-372-9775
Mailing Address - Street 1:945 W STACY RD STE 110
Mailing Address - Street 2:
Mailing Address - City:ALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:75013-5076
Mailing Address - Country:US
Mailing Address - Phone:972-372-9775
Mailing Address - Fax:866-871-3775
Practice Address - Street 1:945 W STACY RD STE 110
Practice Address - Street 2:
Practice Address - City:ALLEN
Practice Address - State:TX
Practice Address - Zip Code:75013-5076
Practice Address - Country:US
Practice Address - Phone:972-372-9775
Practice Address - Fax:866-871-3775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-22
Last Update Date:2018-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy