MEDICARE: JG PHARMACY INC

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	11017	TX
2	3336C0003X	Community/Retail Pharmacy

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	4568424	OTHER		OTHER ID NUMBER-COMMERCIAL NUMBER

General Provider Information

NPI Number	:	1194736686
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JG PHARMACY INC

Provider Business Mailing Address
First Line	:	3745 WESTHEIMER RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77027-5227
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3745 WESTHEIMER RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77027-5227
Country	:	US
Telephone Number	:	713-527-8339
Fax Number	:	713-527-8322

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JIM GREADY
Credential	:
Telephone Number	:	713-527-8339

Provider Enumeration Date	:	08/10/2006
Last Update Date	:	09/11/2025

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