MEDICARE: NALZ 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	3336C0003X	Community/Retail Pharmacy

Other Identifiers

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

General Provider Information

NPI Number	:	1881182673
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NALZ CORPORATION

Provider Business Mailing Address
First Line	:	5420 DASHWOOD DR STE 201
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77081-5332
Country	:	US
Telephone Number	:	346-406-5095
Fax Number	:	346-406-5096

Provider Business Practice Location Address
First Line	:	5420 DASHWOOD DR STE 201
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77081-5332
Country	:	US
Telephone Number	:	346-406-5095
Fax Number	:	346-406-5096

Authorized Official
Title or Position	:	MANAGER
Name	:	DR. JOSEPH GHEBREMICHAEL
Credential	:	PHARM.D.
Telephone Number	:	281-520-5367

Provider Enumeration Date	:	04/26/2018
Last Update Date	:	01/21/2020

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Directions to “NALZ CORPORATION ” Practice Location

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