Organization Name: | EXECUTIVE HEALTH, LLC |
NPI Number: | 1487800165 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SEMYON NAROSOV (PRESIDENT) |
Mailing Address: | 6303 Forest Park Rd Ste 255a Dallas |
State: | TX US |
Postal Code: | 752355472 |
Phone Number: | 2143578889 |
Fax Number: | 2143578370 |
NPI Enumeration Date: | 08/13/2008 |
NPI Last Update Date: | 08/13/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 333600000X |
License Number: | 25175 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Pharmacy |
Taxonomy Specialization: | |
Taxonomy Definition: | A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |