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General NPI Number Information
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NPI Number | 1710343041
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Entity Type | Organization
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Legal Business Name | ACARIAHEALTH PHARMACY #11, INC.
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Dates
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Enumeration Date | 12/31/2015
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Last Update Date | 03/11/2020
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Provider Practice Location Address
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Address Line | 1311 W SAM HOUSTON PKWY N 130
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City | HOUSTON
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State | TX
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Zip | 77043-4010
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Country | US
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Telephone | 832-900-1367
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Fax | 713-654-8021
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Provider Business Mailing Address
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Address Line | 6923 LEE VISTA BLVD STE 300
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City | ORLANDO
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State | FL
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Zip | 32822-4703
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Country | US
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Telephone | 855-422-2742
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Fax | 866-834-8523
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Authorized Official
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Title or Position | PRESIDENT
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Name | STEPHEN JENSEN
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Credential |
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Telephone | 800-511-5144
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 25485
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License Number State | TX
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