Provider Demographics
NPI:1831592393
Name:FOREST DRUG STORE LLC
Entity type:Organization
Organization Name:FOREST DRUG STORE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:PRINGLE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:469-323-1392
Mailing Address - Street 1:9550 FOREST LN
Mailing Address - Street 2:SUITE 606
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75243-5905
Mailing Address - Country:US
Mailing Address - Phone:469-804-7929
Mailing Address - Fax:469-804-7930
Practice Address - Street 1:9550 FOREST LN
Practice Address - Street 2:SUITE 606
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75243-5905
Practice Address - Country:US
Practice Address - Phone:469-804-7929
Practice Address - Fax:469-804-7930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-29
Last Update Date:2014-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0002XSuppliersPharmacyClinic Pharmacy