Fiesta Lifecare Pharmacy 4, Llc

LBN: Fiesta Lifecare Pharmacy 4 Llc
Fiesta Lifecare Pharmacy 4, Llc is an health care organization with primary practice located at 4202 Pioneer Rd , Balch Springs TX 75180-3537. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Fiesta Lifecare Pharmacy 4 Llc can be contacted via phone (972) 557-3535, or through Kalidindi, Prem via phone (917) 769-8014.

Contact Information

Primary practice address
4202 Pioneer Rd Balch Springs TX 75180-3537
Phone: (972) 557-3535
Fax: (972) 557-4187
Website:
Map and Directions
Authorized official contact:
Name: Kalidindi, Prem
Phone: (917) 769-8014

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 31266 Texas

Profile Details

NPI number 1356883821
LBN Legal business name Fiesta Lifecare Pharmacy 4 Llc
DBA Doing business as Fiesta Lifecare Pharmacy 4, Llc
Authorized official Kalidindi, Prem
Entity Organization
Organization subpart 1 No
Enumeration date Nov 15th, 2016
Last updated Jul 27th, 2018 - about 8 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356883821 NPPES
Other 2164063 PK
MEDICAID 149595 PK

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