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General NPI Number Information
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NPI Number | 1669819900
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Entity Type | Organization
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Legal Business Name | DISTINGUISHED PHARMACEUTICALS LLC
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Dates
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Enumeration Date | 05/28/2013
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Last Update Date | 09/15/2020
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Provider Practice Location Address
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Address Line | 12134 BEECHNUT STREET
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City | HOUSTON
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State | TX
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Zip | 77072
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Country | US
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Telephone | 281-495-0201
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Fax | 281-495-0200
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Provider Business Mailing Address
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Address Line | 12134 BEECHNUT STREET
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City | HOUSTON
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State | TX
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Zip | 77072
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Country | US
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Telephone | 281-495-0201
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Fax | 281-495-0200
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Authorized Official
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Title or Position | CORPORATE OFFICER
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Name | NOEL CHUKWUEKE
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Credential |
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Telephone | 855-795-7004
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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 | 28435
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License Number State | TX
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