Provider Demographics
NPI:1093359671
Name:ESSENTIALS PHARMACY, LLC
Entity Type:Organization
Organization Name:ESSENTIALS PHARMACY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:CORTNEY
Authorized Official - Middle Name:
Authorized Official - Last Name:MORRIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-888-9159
Mailing Address - Street 1:451 FM 646 RD E STE C1
Mailing Address - Street 2:
Mailing Address - City:DICKINSON
Mailing Address - State:TX
Mailing Address - Zip Code:77539-3010
Mailing Address - Country:US
Mailing Address - Phone:281-888-9159
Mailing Address - Fax:281-501-9909
Practice Address - Street 1:451 FM 646 RD E STE C1
Practice Address - Street 2:
Practice Address - City:DICKINSON
Practice Address - State:TX
Practice Address - Zip Code:77539-3010
Practice Address - Country:US
Practice Address - Phone:281-888-9159
Practice Address - Fax:281-501-9909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-11-06
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX150305Medicaid