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General NPI Number Information
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NPI Number | 1821551193
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Entity Type | Organization
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Legal Business Name | SUPERFAST PHARMACY AND MEDICAL SUPPLIES LLC
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Dates
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Enumeration Date | 04/12/2019
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Last Update Date | 04/12/2019
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Provider Practice Location Address
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Address Line | 11690 SPRING CYPRESS RD STE 100
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City | TOMBALL
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State | TX
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Zip | 77377-8938
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Country | US
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Telephone | 281-513-7960
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Fax |
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Provider Business Mailing Address
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Address Line | 228 DOVE MEADOW DR
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City | CONROE
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State | TX
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Zip | 77384-1416
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Country | US
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Telephone | 281-513-7960
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Fax |
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Authorized Official
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Title or Position | MEMBER OF LLC
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Name | PRACHI PATEL
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Credential |
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Telephone | 281-513-7960
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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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