Provider Demographics
NPI:1376602375
Name:NATIONAL HEALTH PHARMACY LTD
Entity Type:Organization
Organization Name:NATIONAL HEALTH PHARMACY LTD
Other - Org Name:CLEAR LAKE PROFESSIONAL BLDG PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUNG
Authorized Official - Middle Name:
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:281-332-2496
Mailing Address - Street 1:251 W MEDICAL CENTER BLVD
Mailing Address - Street 2:STE 100
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-4242
Mailing Address - Country:US
Mailing Address - Phone:281-332-2496
Mailing Address - Fax:281-332-3672
Practice Address - Street 1:251 W MEDICAL CENTER BLVD
Practice Address - Street 2:STE 100
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4242
Practice Address - Country:US
Practice Address - Phone:281-332-2496
Practice Address - Fax:281-332-3672
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-06
Last Update Date:2016-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
TX037303336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX142469Medicaid
2092819OtherPK