MEDICARE: NV CREATIVE 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	3336L0003X	Long Term Care Pharmacy
3	3336C0003X	Community/Retail Pharmacy	28811	TX

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
2	2142277	OTHER		PK

General Provider Information

NPI Number	:	1346676160
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NV CREATIVE INC

Provider Business Mailing Address
First Line	:	714 W CHURCH ST
Second Line	:
City	:	LIVINGSTON
State	:	TX
Zip	:	77351-3109
Country	:	US
Telephone Number	:	936-327-5510
Fax Number	:	936-327-4602

Provider Business Practice Location Address
First Line	:	714 W CHURCH ST
Second Line	:
City	:	LIVINGSTON
State	:	TX
Zip	:	77351-3109
Country	:	US
Telephone Number	:	936-327-5510
Fax Number	:	936-327-4602

Authorized Official
Title or Position	:	OFFICER
Name	:	NIPUL K PATEL
Credential	:
Telephone Number	:	281-593-3800

Provider Enumeration Date	:	09/25/2013
Last Update Date	:	02/13/2023

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Directions to “NV CREATIVE INC ” Practice Location

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