NPIMap

Organization Active NPI

Executive Healthcare

Doing business as The Apothecary Shop

  • Community/Retail Pharmacy
  • Dallas, TX
National Provider Identifier
1598865800
Registry record updated Dec 10, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
26627 Issued in TX
Legal business name
EXECUTIVE HEALTHCARE
Doing business as
The Apothecary Shop
Practice address
6303 Forest Park Rd
Ste a 255
Dallas, TX 75235-5450
Phone
(214) 357-8889
Fax
(214) 357-8370
NPI assigned
Sep 25, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2015

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

Authorized official

Name
Semyon Narosov
Title
Owner
Phone
(214) 357-8889

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 26627 TX Primary
Compounding Pharmacy 3336C0004X

Addresses

Primary practice location

6303 Forest Park Rd
Ste a 255
Dallas, TX 75235-5450

Mailing address

PO Box 797604
Dallas, TX 75379-7604
Phone (972) 702-9310

Other identifiers 1

IdentifierTypeStateIssuer
2091865OtherPK

Other names 1

  • The Apothecary Shop Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Allied Tri-Med4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449705600000",
    "number": "1598865800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 797604",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753797604",
            "telephone_number": "972-702-9310",
            "fax_number": "972-458-7111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6303 FOREST PARK RD",
            "address_2": "STE A 255",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752355450",
            "telephone_number": "214-357-8889",
            "fax_number": "214-357-8370"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXECUTIVE HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-25",
        "last_updated": "2015-12-10",
        "status": "A",
        "authorized_official_last_name": "NAROSOV",
        "authorized_official_first_name": "SEMYON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "214-357-8889"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "TX",
            "license": "26627",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2091865",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Apothecary Shop",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Dallas, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2015; 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.