MEDICARE: CANAL HEALTHCARE SOLUTIONS LLC

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	27707	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2132600	OTHER		PK

General Provider Information

NPI Number	:	1487979597
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CANAL HEALTHCARE SOLUTIONS LLC

Provider Business Mailing Address
First Line	:	7648 CANAL ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77012-1144
Country	:	US
Telephone Number	:	713-924-6067
Fax Number	:	866-540-4321

Provider Business Practice Location Address
First Line	:	7648 CANAL ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77012-1144
Country	:	US
Telephone Number	:	713-924-6067
Fax Number	:	866-540-4321

Authorized Official
Title or Position	:	PHARMACIST
Name	:	MARCUS POWELL
Credential	:
Telephone Number	:	713-924-6067

Provider Enumeration Date	:	03/31/2010
Last Update Date	:	07/19/2018

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Directions to “CANAL HEALTHCARE SOLUTIONS LLC ” Practice Location

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