MEDICARE: E&E PHARMACY

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	31822	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2128856	OTHER		PK

General Provider Information

NPI Number	:	1093017337
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	E&E PHARMACY

Provider Business Mailing Address
First Line	:	7008 WOODRIDGE DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77087-2712
Country	:	US
Telephone Number	:	713-847-8989
Fax Number	:	713-847-8900

Provider Business Practice Location Address
First Line	:	7008 WOODRIDGE DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77087-2712
Country	:	US
Telephone Number	:	713-847-8989
Fax Number	:	713-847-8900

Authorized Official
Title or Position	:	PHARMACIST-IN-CHARGE
Name	:	DOROTHY ETTA
Credential	:
Telephone Number	:	713-847-8989

Provider Enumeration Date	:	11/18/2010
Last Update Date	:	05/03/2018

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Directions to “E&E PHARMACY ” Practice Location

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