MEDICARE: KASHMERE 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
2	3336C0003X	Community/Retail Pharmacy	17580	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2101901	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1346234549
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KASHMERE PHARMACY INC

Provider Business Mailing Address
First Line	:	6402 LYONS AVE
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77020-4917
Country	:	US
Telephone Number	:	713-674-6916
Fax Number	:	713-673-3297

Provider Business Practice Location Address
First Line	:	6402 LYONS AVE
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77020-4917
Country	:	US
Telephone Number	:	713-674-6916
Fax Number	:	713-673-3297

Authorized Official
Title or Position	:	VICE PRESIDENT
Name	:	TERRENCE MYERS
Credential	:
Telephone Number	:	713-674-6916

Provider Enumeration Date	:	09/02/2005
Last Update Date	:	12/07/2016

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Directions to “KASHMERE PHARMACY INC ” Practice Location

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