Provider Demographics
NPI:1518111210
Name:AAARK GROUP INC
Entity Type:Organization
Organization Name:AAARK GROUP INC
Other - Org Name:1960 PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANSON
Authorized Official - Middle Name:
Authorized Official - Last Name:MATHEW
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-893-6000
Mailing Address - Street 1:5202 BISSONNET ST STE B
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-3910
Mailing Address - Country:US
Mailing Address - Phone:281-893-6000
Mailing Address - Fax:281-893-6001
Practice Address - Street 1:5202 BISSONNET ST STE B
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-3910
Practice Address - Country:US
Practice Address - Phone:281-893-6000
Practice Address - Fax:281-893-6001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-07
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X
TX261943336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX145982Medicaid
2117730OtherPK