MEDICARE: EAST END PHARMACY, INC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy	00555	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063553238
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	EAST END PHARMACY, INC.

Provider Business Mailing Address
First Line	:	6802 NAVIGATION BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77011-1453
Country	:	US
Telephone Number	:	713-923-5959
Fax Number	:

Provider Business Practice Location Address
First Line	:	6802 NAVIGATION BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77011-1453
Country	:	US
Telephone Number	:	713-923-5959
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MR. SIDNEY LEFKOWITZ
Credential	:	RPH
Telephone Number	:	713-923-5959

Provider Enumeration Date	:	02/09/2007
Last Update Date	:	08/22/2020

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Directions to “EAST END PHARMACY, INC. ” Practice Location

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