Provider Demographics
NPI:1689124463
Name:ALIANA ENTERPRISE INC
Entity Type:Organization
Organization Name:ALIANA ENTERPRISE INC
Other - Org Name:HOMETOWN PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PIC
Authorized Official - Prefix:
Authorized Official - First Name:ANNA
Authorized Official - Middle Name:
Authorized Official - Last Name:GELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-437-2877
Mailing Address - Street 1:1251 PIN OAK RD STE 127
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-5659
Mailing Address - Country:US
Mailing Address - Phone:832-437-2877
Mailing Address - Fax:832-913-8735
Practice Address - Street 1:1251 PIN OAK RD STE 127
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-5659
Practice Address - Country:US
Practice Address - Phone:832-437-2877
Practice Address - Fax:832-913-8735
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-05
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0004X
TX310303336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2164541OtherPK