Polk, Andrea
Polk, Andrea is an sole proprietor health care provider with primary practice located at 2001 W John Carpenter Fwy , Irving TX 75063-3255. She recently has only one registered license in Suppliers / Clinic Pharmacy, which is considered as her primary health care specialty. Polk, Andrea can be contacted via phone (800) 379-0092.Contact Information
Primary practice address
2001 W John Carpenter Fwy
Irving TX 75063-3255
Phone: (800) 379-0092
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Clinic Pharmacy | 3336C0002X | 1124201215 | Texas |
Profile Details
| NPI number | 1255077293 |
|---|---|
| LBN Legal business name | Polk, Andrea |
| Credentials | CPHT |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 11th, 2022 |
| Last updated | May 11th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1255077293 | NPPES |
| Texas | Other | 102239 | STATE PHARMACY LICENSE |
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