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Contact Information

ANDREA POLK, CPHT
2001 W JOHN CARPENTER FWY
IRVING, TX75063-3255
 Phone: 800-379-0092
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinic Pharmacy

3336C0002X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for

NPI # 1255077293
Entity Organization
Organization subpart 1 Not specified
Enumeration date 05/11/2022
Last updated 05/11/2022 - About 4 years ago
Identifiers
TX License # 1124201215
TX Other 102239 STATE PHARMACY LICENSE
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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