=====================================================
General NPI Number Information
=====================================================
NPI Number | 1043674518
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | GREENBUSCH PHARMACY INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/11/2016
-----------------------------------------------------
Last Update Date | 10/28/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 26717 WESTHEIMER PKWY STE 301
-----------------------------------------------------
City | KATY
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77494-8058
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 832-437-1130
-----------------------------------------------------
Fax | 832-201-0839
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 26717 WESTHEIMER PKWY STE 301
-----------------------------------------------------
City | KATY
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77494-8058
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 832-437-1130
-----------------------------------------------------
Fax | 832-201-0839
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PIC
-----------------------------------------------------
Name | SYLVIE LEOCADIE KONHAWA KAMDEM
-----------------------------------------------------
Credential | PHARM D
-----------------------------------------------------
Telephone | 832-437-1130
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number | 30761
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------