Provider Demographics
NPI:1538633326
Name:METHODIST COMMUNITY PHARMACY, LLC
Entity type:Organization
Organization Name:METHODIST COMMUNITY PHARMACY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:TREASURER AND VP OF COMPLIANCE
Authorized Official - Prefix:
Authorized Official - First Name:JON
Authorized Official - Middle Name:
Authorized Official - Last Name:ALBRECHT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:214-947-2504
Mailing Address - Street 1:1441 N BECKLEY AVE LBBY B
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75203-1201
Mailing Address - Country:US
Mailing Address - Phone:214-933-6050
Mailing Address - Fax:214-933-6057
Practice Address - Street 1:1441 N BECKLEY AVE LBBY B
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75203-1201
Practice Address - Country:US
Practice Address - Phone:214-933-6050
Practice Address - Fax:214-933-6057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-15
Last Update Date:2019-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy