QVL Pharmacy 147 LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

28346 Issued in TX

Legal business name

QVL PHARMACY 147 LLC

Doing business as

QVL Pharmacy #147

Practice address

3751 Matlock Rd Ste 121
Arlington, TX 76015-4342

Phone

(682) 300-2303

Fax

(682) 300-2304

NPI assigned

Dec 3, 2012

Organization subpart

No

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

Authorized official

Name

Gary Chad Collins

Title

Ceo

Phone

(214) 624-3050

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• QVL Pharmacy #147 Doing business as

Locations

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

{
    "created_epoch": "1354492800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1402963200000",
    "number": "1386989325",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 803493",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753803493",
            "telephone_number": "214-624-3073",
            "fax_number": "214-989-7986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3751 MATLOCK RD STE 121",
            "city": "ARLINGTON",
            "state": "TX",
            "postal_code": "760154342",
            "telephone_number": "682-300-2303",
            "fax_number": "682-300-2304"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "QVL PHARMACY 147 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-03",
        "last_updated": "2014-06-17",
        "status": "A",
        "authorized_official_last_name": "COLLINS",
        "authorized_official_first_name": "GARY CHAD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "214-624-3050"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "28346",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2138018",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "466884",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "QVL Pharmacy #147",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Arlington, TX
• Providers in Arlington, TX by specialty
• Community/Retail Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2014; 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.