Provider Demographics
NPI:1073061867
Name:FIRST CLASS PHARMACIES LLC,CORP
Entity Type:Organization
Organization Name:FIRST CLASS PHARMACIES LLC,CORP
Other - Org Name:CREATIVE CARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:MS
Authorized Official - First Name:KESHA
Authorized Official - Middle Name:LYNETTE
Authorized Official - Last Name:HARRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-731-5727
Mailing Address - Street 1:11601 SHADOW CREEK PARKWAY
Mailing Address - Street 2:SUITE 111, #549
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584
Mailing Address - Country:US
Mailing Address - Phone:713-785-1156
Mailing Address - Fax:713-785-1165
Practice Address - Street 1:6423 RICHMOND AVE STE G
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77057-5926
Practice Address - Country:US
Practice Address - Phone:713-785-1156
Practice Address - Fax:713-785-1165
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-21
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX309983336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy