Provider Demographics
NPI:1982615571
Name:CUT-RATE PHARMACY
Entity Type:Organization
Organization Name:CUT-RATE PHARMACY
Other - Org Name:CUT RATE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLARD
Authorized Official - Middle Name:
Authorized Official - Last Name:STIMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-630-3014
Mailing Address - Street 1:3528 N HAMPTON RD
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75212-2442
Mailing Address - Country:US
Mailing Address - Phone:214-630-3014
Mailing Address - Fax:214-688-5289
Practice Address - Street 1:3528 N HAMPTON RD
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75212-2442
Practice Address - Country:US
Practice Address - Phone:214-630-3014
Practice Address - Fax:214-688-5289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2011-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
TX58023336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4517251OtherNCPDP PROVIDER IDENTIFICATION NUMBER
TX142022Medicaid