Provider Demographics
NPI:1326324526
Name:SPARTAN PHARMACY
Entity Type:Organization
Organization Name:SPARTAN PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VP
Authorized Official - Prefix:
Authorized Official - First Name:T
Authorized Official - Middle Name:E
Authorized Official - Last Name:MEANS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-449-6400
Mailing Address - Street 1:2327 FM 1960 RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77073-2501
Mailing Address - Country:US
Mailing Address - Phone:281-449-6400
Mailing Address - Fax:
Practice Address - Street 1:2327 FM 1960 RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77073-2501
Practice Address - Country:US
Practice Address - Phone:281-449-6400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-11-01
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX27680333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy