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General NPI Number Information
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NPI Number | 1659674265
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Entity Type | Organization
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Legal Business Name | CK'S PHARMACY
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Dates
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Enumeration Date | 12/21/2010
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Last Update Date | 12/21/2010
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Provider Practice Location Address
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Address Line | 5405 T C JESTER BLVD STE H
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City | HOUSTON
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State | TX
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Zip | 77091-5239
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Country | US
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Telephone | 713-686-4155
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Fax | 713-686-4158
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Provider Business Mailing Address
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Address Line | 5405 T. C. JESTER BLVD SUITE H
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City | HOUSTON
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State | TX
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Zip | 77091
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Country | US
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Telephone | 713-686-4155
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Fax | 713-686-4158
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Authorized Official
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Title or Position | OWNER
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Name | CLEOOPHUS KENNEDY
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Credential |
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Telephone | 713-686-4155
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 27114
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License Number State | TX
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