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General NPI Number Information
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NPI Number | 1619335247
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Entity Type | Organization
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Legal Business Name | MEDLITE LLC
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Dates
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Enumeration Date | 02/10/2016
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Last Update Date | 10/09/2025
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Provider Practice Location Address
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Address Line | 16506 FM 529 RD #108
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City | HOUSTON
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State | TX
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Zip | 77095-1462
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Country | US
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Telephone | 281-815-7366
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Fax | 281-815-7258
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Provider Business Mailing Address
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Address Line | 16506 FM 529 RD STE 108
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City | HOUSTON
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State | TX
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Zip | 77095-1462
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Country | US
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Telephone | 281-815-7366
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Fax | 281-815-7258
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Authorized Official
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Title or Position | OWNER
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Name | MR. KENNEDY EHIMARE IJIE SR.
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Credential | R.PH
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Telephone | 281-815-7366
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 305S00000X
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Taxonomy Name | Point of Service
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License Number |
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License Number State | TX
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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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