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General NPI Number Information
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NPI Number | 1508123969
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Entity Type | Organization
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Legal Business Name | SPECIALTY PHARMACEUTICAL SOLUTIONS, LLC
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Dates
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Enumeration Date | 04/23/2012
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Last Update Date | 09/06/2012
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Provider Practice Location Address
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Address Line | 6550 MAPLERIDGE ST SUITE 222
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City | HOUSTON
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State | TX
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Zip | 77081-4600
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Country | US
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Telephone | 855-567-3432
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Fax | 888-208-1097
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Provider Business Mailing Address
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Address Line | 1838 ELM HILL PIKE SUITE 108
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City | NASHVILLE
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State | TN
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Zip | 37210-3726
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Country | US
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Telephone | 855-567-3432
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Fax | 888-208-1097
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | CLINT FOWLER
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Credential |
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Telephone | 281-851-7506
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number | 27893
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License Number State | TX
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