Provider Demographics
NPI:1033450739
Name:HEALTHCHOICE PHARMACY LLC
Entity Type:Organization
Organization Name:HEALTHCHOICE PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CEDRICK
Authorized Official - Middle Name:JERMAINE
Authorized Official - Last Name:BURNS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-291-6245
Mailing Address - Street 1:10001 WEST BELLFORT
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77031
Mailing Address - Country:US
Mailing Address - Phone:281-741-8358
Mailing Address - Fax:
Practice Address - Street 1:10001 WEST BELLFORT
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77031
Practice Address - Country:US
Practice Address - Phone:281-741-8358
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-06
Last Update Date:2013-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy