MEDICARE: KIM MORE PHARMACY CORPORATION

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	25328	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	2099902	OTHER		PK

General Provider Information

NPI Number	:	1699830026
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KIM MORE PHARMACY CORPORATION

Provider Business Mailing Address
First Line	:	PO BOX 720712
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77272-0712
Country	:	US
Telephone Number	:	713-777-1414
Fax Number	:	713-777-1417

Provider Business Practice Location Address
First Line	:	7601 W SAM HOUSTON PKWY S
Second Line	:	STE 900
City	:	HOUSTON
State	:	TX
Zip	:	77072-5227
Country	:	US
Telephone Number	:	713-777-1414
Fax Number	:	713-777-1417

Authorized Official
Title or Position	:	OWNER
Name	:	STEPHEN KRAUSE
Credential	:
Telephone Number	:	713-777-1414

Provider Enumeration Date	:	12/26/2006
Last Update Date	:	11/17/2015

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Directions to “KIM MORE PHARMACY CORPORATION ” Practice Location

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