Provider Demographics
NPI:1144874967
Name:CAPSULE DALLAS LLC
Entity type:Organization
Organization Name:CAPSULE DALLAS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:ERIC
Authorized Official - Middle Name:
Authorized Official - Last Name:KINARIWALA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:888-685-9515
Mailing Address - Street 1:122 W 146TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10039-3802
Mailing Address - Country:US
Mailing Address - Phone:888-685-9515
Mailing Address - Fax:646-934-6409
Practice Address - Street 1:2909 MCKINNEY AVE STE A
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204-7479
Practice Address - Country:US
Practice Address - Phone:214-214-6002
Practice Address - Fax:646-934-6409
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CAPSULE CORPORATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-07-30
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy