MEDICARE: POWER CENTER 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
2	3336C0003X	Community/Retail Pharmacy	24969	TX

General Provider Information

NPI Number	:	1295756260
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	POWER CENTER PHARMACY INC

Provider Business Mailing Address
First Line	:	8803 SCOTT ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77051-2453
Country	:	US
Telephone Number	:	713-731-8999
Fax Number	:	713-731-8980

Provider Business Practice Location Address
First Line	:	8803 SCOTT ST
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77051-2453
Country	:	US
Telephone Number	:	713-731-8999
Fax Number	:	713-731-8980

Authorized Official
Title or Position	:	OFFICER
Name	:	MS. OKSANA HOWARD
Credential	:
Telephone Number	:	713-721-3303

Provider Enumeration Date	:	07/22/2006
Last Update Date	:	10/25/2019

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