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General NPI Number Information
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NPI Number | 1477954162
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Entity Type | Organization
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Legal Business Name | GENOVATIONS PHARMACY LLC
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Dates
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Enumeration Date | 09/12/2014
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Last Update Date | 05/05/2015
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Provider Practice Location Address
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Address Line | 10301 STELLA LINK RD STE C
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City | HOUSTON
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State | TX
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Zip | 77025-5447
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Country | US
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Telephone | 832-941-0850
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Fax | 832-941-0849
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Provider Business Mailing Address
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Address Line | 10301 STELLA LINK RD STE C
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City | HOUSTON
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State | TX
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Zip | 77025-5447
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Country | US
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Telephone | 832-941-0850
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Fax | 832-941-0849
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Authorized Official
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Title or Position | PHARMACY OPERATIONS MANAGER
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Name | CLAUDIA KIM
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Credential |
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Telephone | 832-701-0422
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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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Taxonomy #2
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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 #3
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Taxonomy Code | 3336M0003X
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Taxonomy Name | Managed Care Organization Pharmacy
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License Number | 29959
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License Number State | TX
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