1386256816 NPI number — THE QUEEN LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386256816 NPI number — THE QUEEN LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
THE QUEEN LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
HEALTH FIRST PHARMACY SERVICES
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1386256816
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/02/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1420 FM 1960 BYPASS RD E
Provider Second Line Business Mailing Address:
SUITE 106
Provider Business Mailing Address City Name:
HUMBLE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77338
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
281-318-7557
Provider Business Mailing Address Fax Number:
281-973-8719

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1420 FM 1960 BYPASS RD E
Provider Second Line Business Practice Location Address:
SUITE 106
Provider Business Practice Location Address City Name:
HUMBLE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77338
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-668-1278
Provider Business Practice Location Address Fax Number:
713-668-3180
Provider Enumeration Date:
08/17/2020

Additional Information

Authorized Official

Authorized Official Last Name:
OZIGBOH
Authorized Official First Name:
QUEEN
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER/PIC
Authorized Official Telephone Number:
281-318-7557

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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