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General NPI Number Information
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NPI Number | 1386363323
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Entity Type | Organization
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Legal Business Name | SERVANTS HEART PHARMACY LLC
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Dates
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Enumeration Date | 08/23/2022
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Last Update Date | 10/11/2022
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Provider Practice Location Address
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Address Line | 10110 MONTWOOD DR STE I
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City | EL PASO
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State | TX
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Zip | 79925-6244
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Country | US
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Telephone | 915-408-3475
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Fax |
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Provider Business Mailing Address
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Address Line | 17350 STATE HIGHWAY 249 STE 220
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City | HOUSTON
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State | TX
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Zip | 77064-1132
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SAMUEL OFOSU MELFAH
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Credential | PHARMD
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Telephone | 915-408-3475
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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 | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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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 | 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 #4
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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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