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General NPI Number Information
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NPI Number | 1881987253
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Entity Type | Organization
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Legal Business Name | RELIANT PHARMACY
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Dates
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Enumeration Date | 05/18/2011
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Last Update Date | 05/18/2011
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Provider Practice Location Address
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Address Line | 9219 S MAIN ST
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City | HOUSTON
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State | TX
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Zip | 77025-4419
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Country | US
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Telephone | 832-778-6500
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Fax | 832-778-6501
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Provider Business Mailing Address
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Address Line | 2005 REIN AVE
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City | ORANGE
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State | TX
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Zip | 77630-3653
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Country | US
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Telephone | 832-778-6500
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Fax | 832-778-6501
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Authorized Official
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Title or Position | OWNER
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Name | SHERRI WEDEL
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Credential |
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Telephone | 409-779-4487
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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 | 27495
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License Number State | TX
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