MEDICARE: GULF INTERNATIONAL PHARMACY, 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	3336C0003X	Community/Retail Pharmacy

General Provider Information

NPI Number	:	1932726155
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GULF INTERNATIONAL PHARMACY, INC

Provider Business Mailing Address
First Line	:	12144 DAIRY ASHFORD RD STE 100G
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77478-6212
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	12144 DAIRY ASHFORD RD STE 100G
Second Line	:
City	:	SUGAR LAND
State	:	TX
Zip	:	77478-6212
Country	:	US
Telephone Number	:	713-562-6775
Fax Number	:

Authorized Official
Title or Position	:	BUSINESS OWNER
Name	:	RASHA SHAHROUR
Credential	:
Telephone Number	:	281-750-2707

Provider Enumeration Date	:	07/03/2020
Last Update Date	:	07/03/2020

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