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General NPI Number Information
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NPI Number | 1538208095
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Entity Type | Organization
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Legal Business Name | RIVERSIDE PHARMACY DBA CANAL PHARMACY
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Dates
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Enumeration Date | 02/05/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2502 CANAL ST
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City | HOUSTON
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State | TX
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Zip | 77003-1523
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Country | US
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Telephone | 713-227-5583
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Fax | 713-224-1918
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Provider Business Mailing Address
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Address Line | 2502 CANAL ST
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City | HOUSTON
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State | TX
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Zip | 77003-1523
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Country | US
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Telephone | 713-227-5583
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Fax | 713-224-1918
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Authorized Official
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Title or Position | OWNER CHIEF PHARMACIST
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Name | CLAUDIA PADILLA
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Credential | RPH
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Telephone | 713-227-5583
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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 | 01335
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License Number State | TX
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