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General NPI Number Information
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NPI Number | 1922589282
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Entity Type | Organization
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Legal Business Name | ALPHADOME PHARMACY INC
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Dates
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Enumeration Date | 08/24/2018
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Last Update Date | 08/24/2018
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Provider Practice Location Address
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Address Line | 1125 BEDFORD RD STE B
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City | BEDFORD
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State | TX
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Zip | 76022-6669
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Country | US
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Telephone | 832-578-3284
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Fax |
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Provider Business Mailing Address
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Address Line | 1125 BEDFORD RD STE B
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City | BEDFORD
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State | TX
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Zip | 76022-6669
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Country | US
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Telephone | 832-578-3284
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | CHINYERE IKOH
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Credential | RPH
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Telephone | 832-578-3284
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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 | 32214
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License Number State | TX
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