Provider Demographics
NPI:1083951800
Name:TOTAL CARE CAC PHARMACY LLC
Entity Type:Organization
Organization Name:TOTAL CARE CAC PHARMACY LLC
Other - Org Name:TOTAL CARE CAC PHARMACY LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:AUGUSTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:NJOKU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-872-4177
Mailing Address - Street 1:14755 NORTH FREEWAY, SUITE 200
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77090
Mailing Address - Country:US
Mailing Address - Phone:281-377-8137
Mailing Address - Fax:281-875-9619
Practice Address - Street 1:14755 NORTH FWY STE 200
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-6503
Practice Address - Country:US
Practice Address - Phone:281-377-8137
Practice Address - Fax:281-875-9619
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-01-14
Last Update Date:2013-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 3336C0004X
TX282363336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5907867OtherNCPDP PROVIDER IDENTIFICATION NUMBER