Provider Demographics
NPI:1164758835
Name:QUICK CK PRESCRIPTION SHOP LLC
Entity Type:Organization
Organization Name:QUICK CK PRESCRIPTION SHOP LLC
Other - Org Name:QUICK CK PRESCRIPTION SHOP LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:HARISH
Authorized Official - Middle Name:
Authorized Official - Last Name:KATHARANI
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:832-831-9465
Mailing Address - Street 1:2656 S LOOP W STE 574
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77054-2664
Mailing Address - Country:US
Mailing Address - Phone:832-831-9465
Mailing Address - Fax:832-831-9467
Practice Address - Street 1:2656 S LOOP W STE 574
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77054-2664
Practice Address - Country:US
Practice Address - Phone:832-831-9465
Practice Address - Fax:832-831-9467
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-30
Last Update Date:2013-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX266403336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2122012OtherPK