Provider Demographics
NPI:1871925982
Name:LEW STERRETT JUSTICE CENTER PHARMACY
Entity type:Organization
Organization Name:LEW STERRETT JUSTICE CENTER PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EVP & CHIEF OPERATING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:EDMUNDO
Authorized Official - Middle Name:
Authorized Official - Last Name:CASTANEDA
Authorized Official - Suffix:
Authorized Official - Credentials:MBA, RN
Authorized Official - Phone:214-590-8006
Mailing Address - Street 1:113 W COMMERCE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75202
Mailing Address - Country:US
Mailing Address - Phone:214-875-2460
Mailing Address - Fax:214-875-2459
Practice Address - Street 1:113 W COMMERCE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75202
Practice Address - Country:US
Practice Address - Phone:214-875-2460
Practice Address - Fax:214-875-2459
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-31
Last Update Date:2024-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX26032OtherPHARMACY