=====================================================
General NPI Number Information
=====================================================
NPI Number | 1891901757
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HILLCROFT PHARMACY, INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/15/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 6400 HILLCROFT ST 107
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77081-3106
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 713-988-9996
-----------------------------------------------------
Fax | 713-988-9446
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 5111 LARKIN ST SUITE A
-----------------------------------------------------
City | HOUSTON
-----------------------------------------------------
State | TX
-----------------------------------------------------
Zip | 77007
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 832-693-3492
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHARMACIST
-----------------------------------------------------
Name | DR. SEAN PAUL YARBROUGH
-----------------------------------------------------
Credential | PHARM.D.
-----------------------------------------------------
Telephone | 832-693-3492
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 3336C0003X
-----------------------------------------------------
Taxonomy Name | Community/Retail Pharmacy
-----------------------------------------------------
License Number | 25524
-----------------------------------------------------
License Number State | TX
-----------------------------------------------------