Provider Demographics
NPI:1982920419
Name:FIVE STAR PHARMACY SERVICES LLC
Entity Type:Organization
Organization Name:FIVE STAR PHARMACY SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PIC
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:HENRY
Authorized Official - Last Name:MCKEE
Authorized Official - Suffix:
Authorized Official - Credentials:PPH
Authorized Official - Phone:214-679-3537
Mailing Address - Street 1:14800 LANDMARK BLVD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75254-7565
Mailing Address - Country:US
Mailing Address - Phone:214-237-4510
Mailing Address - Fax:214-303-1899
Practice Address - Street 1:14800 LANDMARK BLVD
Practice Address - Street 2:SUITE 250
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75254-7565
Practice Address - Country:US
Practice Address - Phone:214-237-4510
Practice Address - Fax:214-303-1899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-08
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX266713336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX4555100OtherNCPCP