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General NPI Number Information
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NPI Number | 1982294898
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Entity Type | Organization
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Legal Business Name | LIFECHEK CARRIZO LLC NITRILIS RX #2
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Dates
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Enumeration Date | 01/25/2021
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Last Update Date | 05/18/2022
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Provider Practice Location Address
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Address Line | 17215 RED OAK DR STE 103
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City | HOUSTON
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State | TX
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Zip | 77090-2611
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Country | US
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Telephone | 281-602-3487
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Fax | 281-407-2056
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Provider Business Mailing Address
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Address Line | PO BOX 1047
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City | RICHMOND
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State | TX
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Zip | 77406-0027
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Country | US
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Telephone | 832-928-9369
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | KARLI M ROYKO
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Credential |
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Telephone | 832-527-1416
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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 #2
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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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