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General NPI Number Information
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NPI Number | 1194430892
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Entity Type | Organization
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Legal Business Name | AGERITE PHARMACY LLC
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Dates
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Enumeration Date | 01/17/2023
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Last Update Date | 01/17/2023
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Provider Practice Location Address
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Address Line | 12827 TELGE RD
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City | CYPRESS
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State | TX
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Zip | 77429-4102
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Country | US
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Telephone | 832-786-9084
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Fax |
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Provider Business Mailing Address
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Address Line | 12827 TELGE RD
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City | CYPRESS
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State | TX
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Zip | 77429-4102
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Country | US
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Telephone | 832-786-9084
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Fax |
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Authorized Official
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Title or Position | CO-OWNER
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Name | DR. CINDY AMAKWE
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Credential | PHARMD, MS
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Telephone | 832-786-9084
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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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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Taxonomy #3
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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 #4
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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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