MEDICARE: CHRISTOPHER GREENE PHARMD

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	183700000X	Pharmacy Technician
2	1835P0018X	Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist	57754	TX

General Provider Information

NPI Number	:	1609164045
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTOPHER GREENE PHARMD

Provider Business Mailing Address
First Line	:	1920 WILLOWICK ST
Second Line	:
City	:	LAKE CHARLES
State	:	LA
Zip	:	70607-2025
Country	:	US
Telephone Number	:	337-377-9891
Fax Number	:

Provider Business Practice Location Address
First Line	:	10010 CYPRESSWOOD DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77070-3408
Country	:	US
Telephone Number	:	337-377-9891
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2011
Last Update Date	:	01/28/2020

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Directions to “ CHRISTOPHER GREENE PHARMD” Practice Location

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