Provider Demographics
NPI:1558846758
Name:INDEPENDENT PHARMACY SERVICES,LLC
Entity Type:Organization
Organization Name:INDEPENDENT PHARMACY SERVICES,LLC
Other - Org Name:LIVE RITE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMEBER
Authorized Official - Prefix:
Authorized Official - First Name:TABITHA
Authorized Official - Middle Name:S
Authorized Official - Last Name:DAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:346-571-5390
Mailing Address - Street 1:3695 KIRBY DR STE 115
Mailing Address - Street 2:
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77584-5544
Mailing Address - Country:US
Mailing Address - Phone:346-571-5390
Mailing Address - Fax:346-867-6353
Practice Address - Street 1:3695 KIRBY DR STE 115
Practice Address - Street 2:
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77584-5544
Practice Address - Country:US
Practice Address - Phone:346-571-5390
Practice Address - Fax:346-867-6353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-03
Last Update Date:2020-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy