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General NPI Number Information
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NPI Number | 1851954796
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Entity Type | Organization
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Legal Business Name | NUBIA APOTHECARY RX LLC
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Dates
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Enumeration Date | 04/16/2019
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Last Update Date | 07/10/2025
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Provider Practice Location Address
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Address Line | 435 FM 1092 RD STE N
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City | STAFFORD
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State | TX
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Zip | 77477-5420
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Country | US
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Telephone | 832-889-7872
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Fax |
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Provider Business Mailing Address
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Address Line | 435 FM 1092 RD STE N
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City | STAFFORD
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State | TX
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Zip | 77477-5420
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Country | US
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Telephone | 281-208-7218
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Fax | 281-208-7220
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | DR. DAMONICA L GORRELL
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Credential | PHARMD
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Telephone | 832-889-7872
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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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 | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number |
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License Number State |
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Taxonomy #5
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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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