MEDICARE: PLAINVIEW PHARMACY

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
2	333600000X	Pharmacy

General Provider Information

NPI Number	:	1235412081
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PLAINVIEW PHARMACY

Provider Business Mailing Address
First Line	:	6618 RAY DR
Second Line	:
City	:	PASADENA
State	:	TX
Zip	:	77505-4197
Country	:	US
Telephone Number	:	832-483-8914
Fax Number	:

Provider Business Practice Location Address
First Line	:	6618 RAY DR
Second Line	:
City	:	PASADENA
State	:	TX
Zip	:	77505-4197
Country	:	US
Telephone Number	:	832-483-8914
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	JOSEPH C KALATHOOR
Credential	:	CPHT
Telephone Number	:	832-483-8914

Provider Enumeration Date	:	09/27/2011
Last Update Date	:	09/27/2011

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Directions to “PLAINVIEW PHARMACY ” Practice Location

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