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Contact Information

LIFESPAN PHARMACY INC
1341 W MOCKINGBIRD LN
SUITE 304W
DALLAS, TX75247
 Phone: 214-220-0007
 Fax: 214-220-2850
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Specialty Pharmacy

3336S0011X 58 Medical Supply Company with Pharmacist
 

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 LIFESPAN PHARMACY INC

NPI Number 1477725398
LBN Legal business name LIFESPAN PHARMACY INC
Authorized official GINA RENNA - (OWNER/OFFICER)
Entity Organization
Organization subpart 1 No
Enumeration date 04/01/2008
Last updated 08/16/2018 - About 8 years ago
Identifiers
TX License # 24217
Other 4525688 NCPDP PROVIDER IDENTIFICATION 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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