MEDICARE: QUALITY DISCOUNT PHARMACEUTICAL 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	3336C0003X	Community/Retail Pharmacy	19623	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2090287	OTHER		PK
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1649374604
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	QUALITY DISCOUNT PHARMACEUTICAL INC

Provider Business Mailing Address
First Line	:	11794 BELLAIRE BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77072-2452
Country	:	US
Telephone Number	:	281-498-5000
Fax Number	:	281-498-7788

Provider Business Practice Location Address
First Line	:	11794 BELLAIRE BLVD
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77072-2452
Country	:	US
Telephone Number	:	281-498-5000
Fax Number	:	281-498-7788

Authorized Official
Title or Position	:	PIC
Name	:	KIM NGO
Credential	:
Telephone Number	:	281-498-5000

Provider Enumeration Date	:	09/12/2006
Last Update Date	:	12/01/2016

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