MEDICARE: SELECT 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	26643	TX

General Provider Information

NPI Number	:	1598094096
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SELECT PHARMACY

Provider Business Mailing Address
First Line	:	3711 HIGHWAY 6 S
Second Line	:	SUITE 150
City	:	HOUSTON
State	:	TX
Zip	:	77082-4313
Country	:	US
Telephone Number	:	281-589-8078
Fax Number	:	281-589-8134

Provider Business Practice Location Address
First Line	:	3711 HIGHWAY 6 S
Second Line	:	SUITE 150
City	:	HOUSTON
State	:	TX
Zip	:	77082-4313
Country	:	US
Telephone Number	:	281-589-8078
Fax Number	:	281-589-8134

Authorized Official
Title or Position	:	OWNER
Name	:	JOYCE POWELL
Credential	:
Telephone Number	:	281-589-8078

Provider Enumeration Date	:	12/11/2009
Last Update Date	:	12/11/2009

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Directions to “SELECT PHARMACY ” Practice Location

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