MEDICARE: REMEDI SENIORCARE OF HOUSTON, LLC

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	3336L0003X	Long Term Care Pharmacy

General Provider Information

NPI Number	:	1073079810
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	REMEDI SENIORCARE OF HOUSTON, LLC

Provider Business Mailing Address
First Line	:	1 OLYMPIC PL STE 600
Second Line	:
City	:	TOWSON
State	:	MD
Zip	:	21204-4110
Country	:	US
Telephone Number	:	443-632-1208
Fax Number	:

Provider Business Practice Location Address
First Line	:	16601 CENTRAL GREEN BLVD STE 300
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77032-5143
Country	:	US
Telephone Number	:	443-632-1208
Fax Number	:

Authorized Official
Title or Position	:	DIRECTOR OF LICENSING
Name	:	MS. MELANIE GREAVER
Credential	:
Telephone Number	:	443-632-1208

Provider Enumeration Date	:	02/18/2019
Last Update Date	:	02/18/2019

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