MEDICARE: DRUG MASTERS 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	3336C0003X	Community/Retail Pharmacy	28235	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5907071	OTHER		NCPDP PROVIDER IDENTIFICATION NUMBER

General Provider Information

NPI Number	:	1881945970
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DRUG MASTERS PHARMACY LLC

Provider Business Mailing Address
First Line	:	1 FLAMINGO ESTATES DR
Second Line	:
City	:	MISSOURI CITY
State	:	TX
Zip	:	77459-4491
Country	:	US
Telephone Number	:	386-290-2944
Fax Number	:

Provider Business Practice Location Address
First Line	:	7208 N SHEPHERD DR STE 106
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77091-2435
Country	:	US
Telephone Number	:	713-884-1686
Fax Number	:	713-884-1682

Authorized Official
Title or Position	:	PHARMACIST IN CHARGE
Name	:	SAJU ASTHAPPAN
Credential	:
Telephone Number	:	386-290-2944

Provider Enumeration Date	:	09/28/2012
Last Update Date	:	09/28/2012

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