Provider Demographics
NPI:1407372311
Name:STARWOOD PHARMACY SERVICES LLC
Entity type:Organization
Organization Name:STARWOOD PHARMACY SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:HANNAH
Authorized Official - Middle Name:
Authorized Official - Last Name:HO
Authorized Official - Suffix:
Authorized Official - Credentials:BS, PHARMD
Authorized Official - Phone:214-618-0052
Mailing Address - Street 1:3550 PARKWOOD BLVD STE 111
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-1904
Mailing Address - Country:US
Mailing Address - Phone:214-618-0052
Mailing Address - Fax:844-785-0697
Practice Address - Street 1:3550 PARKWOOD BLVD STE 111
Practice Address - Street 2:
Practice Address - City:FRISCO
Practice Address - State:TX
Practice Address - Zip Code:75034-1904
Practice Address - Country:US
Practice Address - Phone:214-618-0052
Practice Address - Fax:214-618-1775
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-08-22
Last Update Date:2019-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 3336C0004X, 3336S0011X
TX316153336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX149700Medicaid
2171404OtherPK