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General NPI Number Information
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NPI Number | 1083478028
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Entity Type | Organization
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Legal Business Name | MARCLOY PHARMACY, INC.
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Dates
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Enumeration Date | 02/09/2024
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Last Update Date | 03/28/2024
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Provider Practice Location Address
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Address Line | 3401 EAST BLVD STE 400
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City | DEER PARK
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State | TX
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Zip | 77536-2066
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Country | US
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Telephone | 346-499-7065
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Fax |
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Provider Business Mailing Address
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Address Line | 3401 EAST BLVD STE 400
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City | DEER PARK
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State | TX
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Zip | 77536-2066
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Country | US
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Telephone | 346-499-7065
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Fax | 281-946-8826
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | JOVITA N ACHIFE
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Credential |
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Telephone | 346-499-7065
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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