Provider Demographics
NPI:1578101093
Name:MEMORIAL HERMANN PHARMACY SERVICES, LLC
Entity Type:Organization
Organization Name:MEMORIAL HERMANN PHARMACY SERVICES, LLC
Other - Org Name:MEMORIAL HERMANN PHARMACY - SUGAR LAND
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP- RISK MGMT. & LITIGATION
Authorized Official - Prefix:
Authorized Official - First Name:CHARMAINE
Authorized Official - Middle Name:A
Authorized Official - Last Name:FERGUSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-242-4456
Mailing Address - Street 1:21501 PARK ROW DR STE 200
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-2425
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:17510 W GRAND PKWY S STE 190
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-2647
Practice Address - Country:US
Practice Address - Phone:281-725-5271
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-12-16
Last Update Date:2021-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy