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Contact Information

AT HOME PHARMACY GRAND PRAIRIE LP
4927 LAKE RIDGE PKWY STE 180
GRAND PRAIRIE, TX75052
 Phone: 214-239-9106
 Fax: 214-239-9107
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for AT HOME PHARMACY GRAND PRAIRIE LP

NPI # 1114963600
LBN Legal business name AT HOME PHARMACY GRAND PRAIRIE LP
Authorized official GARY HASTY - (OWNER CEO)
Entity Organization
Organization subpart 1 No
Enumeration date 06/21/2006
Last updated 09/11/2025 - About 9 months ago
Identifiers
TX License # 24380
Other 4539485 OTHER ID NUMBER-COMMERCIAL NUMBER
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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