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UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER AT DALLAS NPI 1992169395


NPI Information

NPI: 1992169395
Provider Name: UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER AT DALLAS

Doing Business As: MONCRIEF CANCER INSTITUTE RETAIL PHARMACY

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

Address:
400 W MAGNOLIA AVE STE 2500
FORT WORTH, TX
ZIP 76104
Phone: (817) 288-9756
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UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER AT DALLAS is a community/retail pharmacy pharmacy in Fort Worth, TX. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER AT DALLAS NPI is 1992169395. The provider is registered as an organization entity type.
The provider Is Doing Business As Moncrief Cancer Institute Retail Pharmacy.

The provider's business location address is:

400 W MAGNOLIA AVE STE 2500
FORT WORTH, TX
ZIP 76104-617
Phone: (817) 288-9756
Fax: (817) 288-0060

The provider's authorized official is Jeff Liticker .
The authorized official title is Pharmacy Manager and has the following contact phone number (214) 645-2681.

The enumeration date for this NPI number is 4/12/2016 and was last updated on 7/18/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1333600000XPharmacyNo
23336C0003XPharmacyCommunity/Retail Pharmacy29894TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
15918733OTHERTEXASNCPDP
22158721OTHERPK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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