MEDICARE: HOMESTEAD 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	3336C0003X	Community/Retail Pharmacy

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	:	1326170580
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HOMESTEAD PHARMACY

Provider Business Mailing Address
First Line	:	8300 HOMESTEAD RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77028-2145
Country	:	US
Telephone Number	:	713-631-3117
Fax Number	:	713-631-1290

Provider Business Practice Location Address
First Line	:	8300 HOMESTEAD RD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77028-2145
Country	:	US
Telephone Number	:	713-631-3117
Fax Number	:	713-631-1290

Authorized Official
Title or Position	:	OWNER VICE PRESIDENT
Name	:	MRS. ANTOINETTE A PORCARELLO
Credential	:
Telephone Number	:	713-631-3117

Provider Enumeration Date	:	03/12/2007
Last Update Date	:	08/22/2020

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Directions to “HOMESTEAD PHARMACY ” Practice Location

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