Professional Plaza Pharmacy Inc
LBN: Professional Plaza Pharmacy Inc
Professional Plaza Pharmacy Inc is an health care organization with primary practice located at 1005 York Dr Suite 105, Desoto TX 75115-2083. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Durable Medical Equipment & Medical Supplies, Suppliers / Community/Retail Pharmacy, Suppliers / Prosthetic/Orthotic Supplier. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Professional Plaza Pharmacy Inc can be contacted via phone (972) 572-1939, or through Adetula, Michael via phone (972) 572-1939.
Contact Information
Primary practice address
1005 York Dr Suite 105
Desoto TX 75115-2083
Phone: (972) 572-1939
Fax: (972) 572-9990
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Durable Medical Equipment & Medical Supplies | 332B00000X | 1313330001 | Texas |
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 19614 | Texas |
| Suppliers / Prosthetic/Orthotic Supplier | 335E00000X | 19614 | Texas |
Profile Details
| NPI number | 1295888394 |
|---|---|
| LBN Legal business name | Professional Plaza Pharmacy Inc |
| DBA Doing business as | |
| Authorized official | Adetula, Michael RPH, PHD |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jan 19th, 2007 |
| Last updated | Jun 17th, 2008 - about 16 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1295888394 | NPPES |
| Texas | MEDICAID | 011191602 | |
| Texas | MEDICAID | 144861 | |
| Texas | Other | 4509165 | |
| Texas | MEDICAID | 011191601 |
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