Provider Demographics
NPI:1871870204
Name:MY PHARMACY
Entity type:Organization
Organization Name:MY PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MOHAMMED
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUSUF
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-768-5840
Mailing Address - Street 1:2920 MOTLEY DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MESQUITE
Mailing Address - State:TX
Mailing Address - Zip Code:75150-3471
Mailing Address - Country:US
Mailing Address - Phone:972-285-3100
Mailing Address - Fax:855-355-3255
Practice Address - Street 1:2920 MOTLEY DR
Practice Address - Street 2:SUITE 200
Practice Address - City:MESQUITE
Practice Address - State:TX
Practice Address - Zip Code:75150-3471
Practice Address - Country:US
Practice Address - Phone:855-355-3155
Practice Address - Fax:855-355-3255
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-14
Last Update Date:2014-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy