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General NPI Number Information
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NPI Number | 1053637983
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Entity Type | Organization
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Legal Business Name | BEECHNUT RX
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Dates
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Enumeration Date | 04/16/2010
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Last Update Date | 04/16/2010
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Provider Practice Location Address
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Address Line | 9510 BEECHNUT STREET STE. G
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City | HOUSTON
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State | TX
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Zip | 77036
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Country | US
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Telephone | 832-668-5410
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Fax | 832-668-5184
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Provider Business Mailing Address
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Address Line | 9510 BEECHNUT STREET STE. G
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City | HOUSTON
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State | TX
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Zip | 77036
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Country | US
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Telephone | 832-668-5410
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Fax | 832-668-5184
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Authorized Official
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Title or Position | MANAGING DIRECTOR
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Name | SANDRA WELLS
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Credential |
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Telephone | 281-777-7196
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 26866
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License Number State | TX
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