MEDICARE: PARAMOUNT PHARMACY 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
1	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	26913	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5900421	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number	:	1487965885
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PARAMOUNT PHARMACY LLC

Provider Business Mailing Address
First Line	:	1304 S LOOP W
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-4010
Country	:	US
Telephone Number	:	713-795-5888
Fax Number	:	281-616-6226

Provider Business Practice Location Address
First Line	:	1304 S LOOP W
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-4010
Country	:	US
Telephone Number	:	713-795-5888
Fax Number	:	281-616-6226

Authorized Official
Title or Position	:	OWNER/DIRECTOR
Name	:	JOHN PARAMBIL
Credential	:
Telephone Number	:	281-217-5223

Provider Enumeration Date	:	06/30/2010
Last Update Date	:	10/03/2011

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Directions to “PARAMOUNT PHARMACY LLC ” Practice Location

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