Provider Demographics
NPI:1598236861
Name:NOVIEMBRE LLC
Entity Type:Organization
Organization Name:NOVIEMBRE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:TATE
Authorized Official - Last Name:STOKES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-563-4777
Mailing Address - Street 1:1611 SCENIC SHORE DR.
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77345
Mailing Address - Country:US
Mailing Address - Phone:832-563-4777
Mailing Address - Fax:281-361-6322
Practice Address - Street 1:200 E. BOOTHE STREET
Practice Address - Street 2:SUITE 103
Practice Address - City:CLEVELAND
Practice Address - State:TX
Practice Address - Zip Code:77327
Practice Address - Country:US
Practice Address - Phone:281-806-7680
Practice Address - Fax:281-806-7681
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-12-16
Last Update Date:2018-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy