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General NPI Number Information
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NPI Number | 1174161244
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Entity Type | Organization
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Legal Business Name | LEGACY COMMUNITY PHARMACY SERVICES
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Dates
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Enumeration Date | 12/19/2019
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Last Update Date | 02/11/2020
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Provider Practice Location Address
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Address Line | 6441 HIGH STAR DR STE 100
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City | HOUSTON
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State | TX
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Zip | 77074-5005
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Country | US
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Telephone | 713-814-3499
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Fax | 832-548-5363
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Provider Business Mailing Address
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Address Line | 1415 CALIFORNIA ST STE 110
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City | HOUSTON
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State | TX
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Zip | 77006-2602
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Country | US
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Telephone | 832-548-5022
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Fax |
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Authorized Official
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Title or Position | SR VP OF PHARMACY
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Name | KAREN GURWITCH
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Credential | RPH
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Telephone | 832-548-5022
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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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