Provider Demographics
NPI:1609694231
Name:HEALTH ONE PHARMACY LLC
Entity type:Organization
Organization Name:HEALTH ONE PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:VADOPPARAMBIL
Authorized Official - Last Name:THOMAS
Authorized Official - Suffix:
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:214-469-2244
Mailing Address - Street 1:3800 MAIN ST STE 102
Mailing Address - Street 2:
Mailing Address - City:THE COLONY
Mailing Address - State:TX
Mailing Address - Zip Code:75056-2838
Mailing Address - Country:US
Mailing Address - Phone:214-469-2244
Mailing Address - Fax:
Practice Address - Street 1:3800 MAIN ST STE 102
Practice Address - Street 2:
Practice Address - City:THE COLONY
Practice Address - State:TX
Practice Address - Zip Code:75056-2838
Practice Address - Country:US
Practice Address - Phone:214-469-2244
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HEALTH ONE PHARMACY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-10-02
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy