A-Class Park Place Pharmacy LLC

Primary specialty

PharmacyTaxonomy code 333600000X

Legal business name

A-CLASS PARK PLACE PHARMACY LLC

Practice address

1001 12TH Ave Ste 156
Fort Worth, TX 76104-3929

Phone

(817) 862-9110

NPI assigned

May 9, 2018

Last updated

Aug 13, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Sam Saleh

Title

Corporate Officer

Phone

(817) 862-9110

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1525824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1597276800000",
    "number": "1134618648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 12TH AVE STE 156",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043929",
            "telephone_number": "817-862-9110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 12TH AVE STE 156",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761043929",
            "telephone_number": "817-862-9110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "A-CLASS PARK PLACE PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-09",
        "last_updated": "2020-08-13",
        "certification_date": "2020-08-13",
        "status": "A",
        "authorized_official_last_name": "SALEH",
        "authorized_official_first_name": "SAM",
        "authorized_official_title_or_position": "CORPORATE OFFICER",
        "authorized_official_telephone_number": "817-862-9110"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pharmacy in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2020; 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.