1144494014 NPI number — TOTAL PHARMACY AND COMPOUNDING SERVICES

Table of content: (NPI 1144494014)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144494014 NPI number — TOTAL PHARMACY AND COMPOUNDING SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TOTAL PHARMACY AND COMPOUNDING SERVICES
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:
Provider Other Organization Name Type Code:
6
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:
1144494014
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/14/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5020 MONTROSE BLVD
Provider Second Line Business Mailing Address:
STE 105
Provider Business Mailing Address City Name:
HOUSTON
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
77006-6533
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
713-528-6337
Provider Business Mailing Address Fax Number:
713-528-7337

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5020 MONTROSE BLVD
Provider Second Line Business Practice Location Address:
STE 105
Provider Business Practice Location Address City Name:
HOUSTON
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
77006-6533
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
713-528-6337
Provider Business Practice Location Address Fax Number:
713-528-7337
Provider Enumeration Date:
04/22/2008

Additional Information

Authorized Official

Authorized Official Last Name:
GILBERT
Authorized Official First Name:
DOWARD
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
713-528-6337

Provider Taxonomy Codes

  • Taxonomy code: 3336C0003X , with the licence number:  25933 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 3336C0004X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 4548042 . This is a "NCPDP PROVIDER IDENTIFICATION NUMBER" identifier . This identifiers is of the category "OTHER".




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