Provider Demographics
NPI:1346234549
Name:KASHMERE PHARMACY INC
Entity Type:Organization
Organization Name:KASHMERE PHARMACY INC
Other - Org Name:KASHMERE PHARMACY INC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:TERRENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:MYERS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-674-6916
Mailing Address - Street 1:6402 LYONS AVE
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77020-4917
Mailing Address - Country:US
Mailing Address - Phone:713-674-6916
Mailing Address - Fax:713-673-3297
Practice Address - Street 1:6402 LYONS AVE
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77020-4917
Practice Address - Country:US
Practice Address - Phone:713-674-6916
Practice Address - Fax:713-673-3297
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-09-02
Last Update Date:2016-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
TX175803336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2101901OtherPK
TX149220Medicaid