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General NPI Number Information
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NPI Number | 1659143683
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Entity Type | Organization
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Legal Business Name | PPC RX PHARMACY LLC
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Dates
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Enumeration Date | 10/24/2023
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Last Update Date | 11/14/2024
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Provider Practice Location Address
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Address Line | 2300 GREEN OAK DR STE 550
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City | KINGWOOD
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State | TX
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Zip | 77339-2048
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Country | US
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Telephone | 832-915-0554
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Fax | 832-430-4524
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Provider Business Mailing Address
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Address Line | 2300 GREEN OAK DR STE 550
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City | KINGWOOD
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State | TX
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Zip | 77339-2048
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Country | US
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Telephone | 281-846-8796
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Fax | 832-430-4524
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Authorized Official
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Title or Position | OWNER/OFFICER
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Name | MS. IGE JOHNSON
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Credential |
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Telephone | 281-846-8796
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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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