LIFECARE PHARMACY OF DALLAS LLC (NPI# 1336692235) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1336692235 |
| Entity Type | Organization |
| Organization Name | LIFECARE PHARMACY OF DALLAS LLC |
| Other Organization Name | LIFECARE PHARMACY OF DALLAS |
| Practice Address |
9709 Bruton Rd Ste 900 Dallas TX 75217-2704 |
| Practice Telephone | 2149427300 |
| Practice Fax Number | 2149427302 |
| Mailing Telephone | 2149427300 |
| Mailing Fax Number | 2149427302 |
| Enumeration Date | 2016-07-27 |
| Last Update Date | 2017-04-10 |
| Authorized Official Name | PREM KALIDINDI (MANAGING MEMBER) |
| Authorized Official Telephone | 9177698014 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| Y | 333600000X | Pharmacy | 31263 | TX | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2162164 | 01 | |
| TX | 145589 | 05 |
| Other Name | Type Code |
|---|---|
| Lifecare Pharmacy of Dallas | Doing Business As Name - Organization |
| Street Address |
9709 BRUTON RD STE 900 |
| City | DALLAS |
| State | TX |
| Zip Code | 75217-2704 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164479671 | Bruton Road Family Medical Association P A | Nurse Practitioner | 9709 Bruton Rd, Suite 800, Dallas, TX 75217-2704 | 2006-05-28 |
| 1962910828 | Mayela Delgado Angeles | Physician Assistant | 9709 Bruton Rd, Dallas, TX 75217-2704 | 2018-01-12 |
| 1083786040 | Patrick Michael Donnelly | Nurse Practitioner | 9709 Bruton Rd, Dallas, TX 75217-2704 | 2006-11-14 |
| 1275576530 | New Era Pharmacy LLC | Pharmacy | 9709 Bruton Rd, Ste 900, Dallas, TX 75217-2704 | 2006-06-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437708682 | Nancy Sutton | Technician | 9335 Homeplace Dr, Dallas, TX 75217 | 2019-09-10 |
| 1194135236 | Phat Dien Truong | Student in an Organized Health Care Education/Training Program | 9709 Bruton Rd., Dallas, TX 75217 | 2014-04-29 |
| 1083039226 | Passage of Youth Family Center, Inc. | Exclusive Provider Organization | 1623 Riverway, Dallas, TX 75217 | 2014-02-25 |
| 1649511270 | First Class Motors Inc. | Private Vehicle | 7710 Great Trinity Forest Way #k, Dallas, TX 75217 | 2013-03-06 |
| 1588969893 | Happy Teeth Dental Centers of Dallas PC | Dentist | 2020 N Masters Dr Suite #100, Dallas, TX 75217 | 2011-01-18 |
| 1891934899 | Shapa Inc | Pharmacy | 9415 Bruton Rd, Ste 3103, Dallas, TX 75217 | 2009-02-13 |
| 1033364450 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 10152 Lake June Rd, Dallas, TX 75217 | 2008-11-26 |
| 1326268533 | Eyad K. Mahrouq | Pharmacist | 1515 S. Buckner Blvd #301, Dallas, TX 75217 | 2007-04-27 |
| 1598886822 | Lake June Medical Center, P.a. | Family Medicine | 7716 Lake June Road, Dallas, TX 75217 | 2007-04-03 |
| 1194869636 | Barbara Jean Cole | Assisted Living Facility | 1364 Gillette St, Dallas, TX 75217 | 2007-02-17 |
| Find all providers in zip 75217 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194349431 | Southern Star Pharmacy 002 | Pharmacy | 7125 Marvin D Love Fwy Ste 105, Dallas, TX 75237-3111 | 2020-06-02 |
| 1386264547 | Amc Pharmacy Inc. | Pharmacy | 655 W Illinois Ave Ste 918, Dallas, TX 75224-1814 | 2020-04-17 |
| 1457918112 | Soch Pharmacy | Pharmacy | 8067 W Virginia Dr # 200, Dallas, TX 75237-3767 | 2019-05-28 |
| 1780159715 | North G Rx LLC | Pharmacy | 9415 Bruton Rd Ste 3104, Dallas, TX 75217-2647 | 2018-10-05 |
| 1699256826 | Arete Group LLC | Pharmacy | 1555 W Mockingbird Ln Ste 208, Dallas, TX 75235-5019 | 2018-08-25 |
| 1427535780 | Medicinesplus LLC | Pharmacy | 2603 Oak Lawn Ave Ste 102, Dallas, TX 75219-4059 | 2018-07-19 |
| 1346727609 | Medicinesplus Integrative Care LLC | Pharmacy | 2603 Oak Lawn Ave Ste 101a, Dallas, TX 75219-4059 | 2018-07-19 |
| 1578093183 | Doughertys Ltc Pharmacy LLC | Pharmacy | 5959 Royal Ln Ste 513, Dallas, TX 75230-3856 | 2017-06-15 |
| 1851838387 | Patmos Consulting LLC | Pharmacy | 5445 La Sierra Dr Ste 202, Dallas, TX 75231-4176 | 2017-01-23 |
| 1518419886 | Rx Professionals LLC | Pharmacy | 1709 Martin Luther King Jr Blvd Ste 2, Dallas, TX 75215-3281 | 2016-11-02 |
| Find all providers in DALLAS | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.