Provider Demographics
NPI:1144266263
Name:CELINA DRUG INCORPORATED
Entity type:Organization
Organization Name:CELINA DRUG INCORPORATED
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JAI
Authorized Official - Middle Name:
Authorized Official - Last Name:HARRIS-ELLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-832-2832
Mailing Address - Street 1:701 N PRESTON RD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:CELINA
Mailing Address - State:TX
Mailing Address - Zip Code:75009-3763
Mailing Address - Country:US
Mailing Address - Phone:972-382-2832
Mailing Address - Fax:972-382-2850
Practice Address - Street 1:701 N PRESTON RD
Practice Address - Street 2:SUITE 210
Practice Address - City:CELINA
Practice Address - State:TX
Practice Address - Zip Code:75009-3763
Practice Address - Country:US
Practice Address - Phone:972-382-2832
Practice Address - Fax:972-382-2850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-20
Last Update Date:2016-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251033336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2094061OtherPK