Organization Active NPI

Prudential Pharmacy

  • Pharmacy
  • Duncanville, TX
National Provider Identifier
1013228162
Registry record updated Jun 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
Legal business name
PRUDENTIAL PHARMACY
Practice address
777 E Wheatland Rd
#100
Duncanville, TX 75116-4918
Phone
(972) 709-4500
Fax
(972) 709-4510
NPI assigned
Jun 23, 2010
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2010

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Tony Ebuehi, PHARMACIST
Title
Pharmacist
Phone
(972) 415-4842

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X Primary

Addresses

Primary practice location

777 E Wheatland Rd
#100
Duncanville, TX 75116-4918

Mailing address

401 W Abram St
Suite B
Arlington, TX 76010-1059
Phone (972) 709-4500

National Provider Directory

National Provider Directory

Locations

777 E Wheatland Rd
Ste 100
Duncanville, TX 75116
Phone (972) 709-4500

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1277251200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277251200000",
    "number": "1013228162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 W ABRAM ST",
            "address_2": "SUITE B",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760101059",
            "telephone_number": "972-709-4500",
            "fax_number": "972-709-4510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "777 E WHEATLAND RD",
            "address_2": "#100",
            "city": "DUNCANVILLE",
            "state": "TX",
            "postal_code": "751164918",
            "telephone_number": "972-709-4500",
            "fax_number": "972-709-4510"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRUDENTIAL PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-23",
        "last_updated": "2010-06-23",
        "status": "A",
        "authorized_official_last_name": "EBUEHI",
        "authorized_official_first_name": "TONY",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "972-415-4842",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMACIST"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Duncanville, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.