Provider Demographics
NPI:1659889160
Name:PHARM HOUSE CARRIZO SPRINGS LLC
Entity Type:Organization
Organization Name:PHARM HOUSE CARRIZO SPRINGS LLC
Other - Org Name:TOWN CENTER PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:COMPLIANCE OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:L
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-454-2848
Mailing Address - Street 1:3531 TOWN CENTER BLVD S STE 103
Mailing Address - Street 2:
Mailing Address - City:SUGAR LAND
Mailing Address - State:TX
Mailing Address - Zip Code:77479-2591
Mailing Address - Country:US
Mailing Address - Phone:844-843-0101
Mailing Address - Fax:844-843-0101
Practice Address - Street 1:3531 TOWN CENTER BLVD S STE 103
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77479-2591
Practice Address - Country:US
Practice Address - Phone:832-876-2516
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-18
Last Update Date:2023-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
TX317593336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2175475OtherPK