Provider Demographics
NPI:1003938275
Name:CHAMPIONS FAMILY PHARMACY INC.
Entity Type:Organization
Organization Name:CHAMPIONS FAMILY PHARMACY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:MATTHEWS
Authorized Official - Last Name:GRANT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-695-5222
Mailing Address - Street 1:4712 AIRLINE DR
Mailing Address - Street 2:SUITE F
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77022-3075
Mailing Address - Country:US
Mailing Address - Phone:713-695-5222
Mailing Address - Fax:713-695-9222
Practice Address - Street 1:4712 AIRLINE DR
Practice Address - Street 2:SUITE F
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77022-3075
Practice Address - Country:US
Practice Address - Phone:713-695-5222
Practice Address - Fax:713-695-9222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-06
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX244533336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy