MEDICARE: HANCOCK PHARMACIES 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	332BN1400X	Nursing Facility Supplies (DME)
2	333600000X	Pharmacy
3	3336L0003X	Long Term Care Pharmacy
4	3336M0002X	Mail Order Pharmacy
5	3336C0003X	Community/Retail Pharmacy	12563	TX

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
2	2097174	OTHER		PK

General Provider Information

NPI Number	:	1710923602
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HANCOCK PHARMACIES INC

Provider Business Mailing Address
First Line	:	4040 S BRAESWOOD BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77025-3304
Country	:	US
Telephone Number	:	713-666-6353
Fax Number	:	713-666-2831

Provider Business Practice Location Address
First Line	:	4040 S BRAESWOOD BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77025-3304
Country	:	US
Telephone Number	:	713-666-6353
Fax Number	:	713-666-2831

Authorized Official
Title or Position	:	PRESIDENT
Name	:	GURBHEJ CHEEMA
Credential	:	PHARMD
Telephone Number	:	713-666-6353

Provider Enumeration Date	:	06/21/2006
Last Update Date	:	12/20/2023

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Directions to “HANCOCK PHARMACIES INC ” Practice Location

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