Healthcare Provider Details

I. General information

NPI: 1942788336
Provider Name (Legal Business Name): PHARMACY INVESTMENT ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/30/2018
Last Update Date: 03/07/2023
Certification Date: 09/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3301 W DAVIS ST STE F
CONROE TX
77304-1872
US

IV. Provider business mailing address

3301 W DAVIS ST STE F
CONROE TX
77304-1872
US

V. Phone/Fax

Practice location:
  • Phone: 936-267-2979
  • Fax: 936-267-2998
Mailing address:
  • Phone: 936-267-2979
  • Fax: 936-267-2998

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number32031
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: PRAMODKUMAR SHAHIWALA
Title or Position: OFFICER
Credential:
Phone: 936-267-2979