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General NPI Number Information
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NPI Number | 1164583233
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Entity Type | Organization
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Legal Business Name | KS PHARM LLC
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Dates
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Enumeration Date | 12/13/2006
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Last Update Date | 07/31/2024
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Provider Practice Location Address
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Address Line | 11555 UNIVERSITY BLVD STE 110
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City | SUGAR LAND
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State | TX
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Zip | 77478-3889
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Country | US
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Telephone | 713-442-9475
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Fax | 713-442-9410
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Provider Business Mailing Address
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Address Line | 11555 UNIVERSITY BLVD
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City | SUGAR LAND
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State | TX
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Zip | 77478
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Country | US
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Telephone | 713-442-9475
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Fax | 713-442-9410
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Authorized Official
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Title or Position | DIRECTOR OF PHARMACY
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Name | LANCE AARON JORDAN
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Credential | R.PH.
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Telephone | 713-442-5251
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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 |
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License Number State |
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