MEDICARE: MONROE CARE 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

General Provider Information

NPI Number	:	1598025280
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MONROE CARE PHARMACY LLC

Provider Business Mailing Address
First Line	:	8529 GULF FWY
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77017
Country	:	UM
Telephone Number	:	713-946-1535
Fax Number	:	713-946-1665

Provider Business Practice Location Address
First Line	:	8529 GULF FWY
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77017-5055
Country	:	US
Telephone Number	:	713-946-1535
Fax Number	:	713-946-1665

Authorized Official
Title or Position	:	OWNER
Name	:	LLOYD DAVID RANDALL
Credential	:
Telephone Number	:	713-946-1535

Provider Enumeration Date	:	05/29/2012
Last Update Date	:	08/21/2012

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