MEDICARE: BEDSIDE MANOR 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

General Provider Information

NPI Number	:	1437769288
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	BEDSIDE MANOR PHARMACY

Provider Business Mailing Address
First Line	:	12401 S POST OAK RD STE 215
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77045-2021
Country	:	US
Telephone Number	:	832-888-7694
Fax Number	:	832-442-4677

Provider Business Practice Location Address
First Line	:	12401 S POST OAK RD STE 215
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77045-2021
Country	:	US
Telephone Number	:	832-888-7694
Fax Number	:	832-442-4677

Authorized Official
Title or Position	:	OWNER/PIC
Name	:	ANGELA LUCRETIA CASSEY
Credential	:	R.PH.
Telephone Number	:	281-888-7694

Provider Enumeration Date	:	08/06/2020
Last Update Date	:	09/02/2021

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Directions to “BEDSIDE MANOR PHARMACY ” Practice Location

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