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NPI Code Detail

MEDICARE: LIFECHEK CARRIZO LLC

MEDICARE: LIFECHEK CARRIZO 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
1333600000XPharmacy
23336L0003XLong Term Care Pharmacy
33336C0003XCommunity/Retail Pharmacy28438TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12138500OTHERPK
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1295777928
Entity Type Code : Organization
Provider Name (Legal Business Name) : LIFECHEK CARRIZO LLC
Provider Business Mailing Address
First Line : 314 N 5TH ST
Second Line : SUITE B
City : CARRIZO SPRINGS
State : TX
Zip : 78834-3106
Country : US
Telephone Number : 830-876-2516
Fax Number : 830-876-5450
Provider Business Practice Location Address
First Line : 3531 TOWN CENTER BLVD S STE 103
Second Line :
City : SUGAR LAND
State : TX
Zip : 77479-2591
Country : US
Telephone Number : 844-843-0101
Fax Number : 844-843-0101
Authorized Official
Title or Position : MANAGING OFFICER
Name : SHAILENDRA GUPTA
Credential :
Telephone Number : 832-290-8997
Provider Enumeration Date : 06/10/2006
Last Update Date : 10/20/2022

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Directions to “LIFECHEK CARRIZO LLC ” Practice Location

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