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General NPI Number Information
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NPI Number | 1467098608
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Entity Type | Organization
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Legal Business Name | CLASSICO ENTERPRISE LLC
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Dates
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Enumeration Date | 11/22/2019
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Last Update Date | 08/24/2022
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Provider Practice Location Address
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Address Line | 10109 BISSONNET ST STE B
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City | HOUSTON
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State | TX
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Zip | 77036-7859
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Country | US
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Telephone | 713-367-1180
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Fax | 281-653-7877
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Provider Business Mailing Address
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Address Line | 10109 BISSONNET ST STE B
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City | HOUSTON
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State | TX
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Zip | 77036-7859
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Country | US
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Telephone | 281-571-7877
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Fax | 281-653-7877
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Authorized Official
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Title or Position | MANAGER
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Name | MR. JASON UZOUKWU
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Credential |
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Telephone | 281-571-7877
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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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