MEDICARE: DUNAMIS PHARMACY, 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	3336C0003X	Community/Retail Pharmacy

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

General Provider Information

NPI Number	:	1538720263
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DUNAMIS PHARMACY, LLC

Provider Business Mailing Address
First Line	:	7030 BRETSHIRE DR STE B
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77016-3704
Country	:	US
Telephone Number	:	281-888-1409
Fax Number	:	281-888-1393

Provider Business Practice Location Address
First Line	:	7030 BRETSHIRE DR STE B
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77016-3704
Country	:	US
Telephone Number	:	281-888-1409
Fax Number	:	281-888-1393

Authorized Official
Title or Position	:	PHARMACIST IN CHARGE
Name	:	DR. GLORIA IFEOMA IGBOANUGO
Credential	:	PHARM.D.
Telephone Number	:	480-310-0564

Provider Enumeration Date	:	06/24/2019
Last Update Date	:	07/03/2023

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Directions to “DUNAMIS PHARMACY, LLC ” Practice Location

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