| Powerhouse Pharmacy Rx Llc | |
|
4740 W Mockingbird Ln Ste 100b Dallas TX 75209-5208 | |
| (214) 350-2900 | |
| (214) 350-2904 |
| Full Name | Powerhouse Pharmacy Rx Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 4740 W Mockingbird Ln Ste 100b, Dallas, Texas |
| Authorized Official Name and Position | Kumudben Shahiwala (OWNER) |
| Authorized Official Contact | 6148860786 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Powerhouse Pharmacy Rx Llc 4740 W Mockingbird Ln Ste 100b Dallas TX 75209-5208 Ph: (214) 350-2900 | Powerhouse Pharmacy Rx Llc 4740 W Mockingbird Ln Ste 100b Dallas TX 75209-5208 Ph: (214) 350-2900 |
| NPI Number | 1982104378 |
|---|---|
| Provider Enumeration Date | 02/13/2018 |
| Last Update Date | 09/11/2024 |
| Medicare PECOS PAC ID | 4587092937 |
|---|---|
| Medicare Enrollment ID | O20200508000252 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982104378 | NPI | - | NPPES |
| 31863 | Other | TX | PROVIDER LICENSE NUMBER |
| 149825 | Medicaid | TX |
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