Provider Demographics
NPI:1124417605
Name:ECO PHARMACY OF SIENNA PLANATION LLC
Entity Type:Organization
Organization Name:ECO PHARMACY OF SIENNA PLANATION LLC
Other - Org Name:ECO PHARMACY OF SIENNA PLANTATION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER,AO
Authorized Official - Prefix:
Authorized Official - First Name:JASMEET
Authorized Official - Middle Name:
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-859-9323
Mailing Address - Street 1:8721 HIGHYWAY 6 SOUTH
Mailing Address - Street 2:#200
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459
Mailing Address - Country:US
Mailing Address - Phone:832-440-0085
Mailing Address - Fax:832-440-7137
Practice Address - Street 1:8721 HIGHWAY 6 # 200
Practice Address - Street 2:
Practice Address - City:MISSOURI CITY
Practice Address - State:TX
Practice Address - Zip Code:77459-7151
Practice Address - Country:US
Practice Address - Phone:832-440-0085
Practice Address - Fax:832-440-7137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-21
Last Update Date:2015-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX297383336C0003X
3336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2149815OtherPK