Provider Demographics
NPI:1487264461
Name:WOORI PHARMACY LLC
Entity type:Organization
Organization Name:WOORI PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:RHEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-678-9398
Mailing Address - Street 1:2405 S STEMMONS FWY STE 220
Mailing Address - Street 2:
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-8770
Mailing Address - Country:US
Mailing Address - Phone:469-968-5000
Mailing Address - Fax:469-968-5002
Practice Address - Street 1:2405 S STEMMONS FWY STE 220
Practice Address - Street 2:
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-8770
Practice Address - Country:US
Practice Address - Phone:469-968-5000
Practice Address - Fax:469-968-5002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-05
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336M0002XSuppliersPharmacyMail Order Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX150384Medicaid