QVL Pharmacy 144, LP

Primary specialty

PharmacyTaxonomy code 333600000X

License

25055 Issued in TX

Legal business name

QVL PHARMACY 144, LP

Doing business as

QVL Pharmacy 144

Practice address

2301 W Walnut St
Garland, TX 75042-6622

Phone

(972) 276-1439

Fax

(972) 276-5631

NPI assigned

May 16, 2006

Last updated

Aug 22, 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

Jeffrey Ross Poliakoff

Title

Chief Executive Officer

Phone

(903) 295-6800

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• QVL Pharmacy 144 Doing business as

Tax ID family

Avenue P Medical Arts PC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Avenue P Medical Arts P.C.

  • Basic Emergency Medical Technician
  • Brooklyn, NY
  • NPI 1366645871
  NPD tax ID

Locations

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1346292562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "911 W LOOP 281",
            "address_2": "SUITE 408",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756042900",
            "telephone_number": "903-295-6800",
            "fax_number": "903-295-3354"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2301 W WALNUT ST",
            "city": "GARLAND",
            "state": "TX",
            "postal_code": "750426622",
            "telephone_number": "972-276-1439",
            "fax_number": "972-276-5631"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QVL PHARMACY 144, LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "POLIAKOFF",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "ROSS",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "903-295-6800"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "TX",
            "license": "25055",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "4540488",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "466270",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "QVL Pharmacy 144",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Kanchana Rajendran

• Pharmacy in Garland, TX
• Providers in Garland, TX by specialty
• Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.