Provider Demographics
NPI:1508001249
Name:HEALTHCO PHARMACY CORP
Entity Type:Organization
Organization Name:HEALTHCO PHARMACY CORP
Other - Org Name:HEALTHCO PHARMACY CORP
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER, PIC
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:713-218-6337
Mailing Address - Street 1:2541 N MACGREGOR WAY STE 100
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77004-7604
Mailing Address - Country:US
Mailing Address - Phone:713-218-6337
Mailing Address - Fax:713-218-6333
Practice Address - Street 1:2541 N MACGREGOR WAY STE 100
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77004-7604
Practice Address - Country:US
Practice Address - Phone:713-218-6337
Practice Address - Fax:713-218-6333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-10
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1835S0206X, 332B00000X, 333600000X, 3336S0011X, 3336S0011X
TX262753336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No1835S0206XPharmacy Service ProvidersPharmacistSolid Organ TransplantGroup - Single Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX145970Medicaid
2118210OtherPK
TX145970Medicaid