Provider Demographics
NPI:1689305450
Name:KS PHARM, LLC
Entity Type:Organization
Organization Name:KS PHARM, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:HUYNH
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:713-442-5251
Mailing Address - Street 1:1001 CAMPBELL RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77055-7407
Mailing Address - Country:US
Mailing Address - Phone:713-442-6920
Mailing Address - Fax:713-442-6921
Practice Address - Street 1:1001 CAMPBELL RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77055-7407
Practice Address - Country:US
Practice Address - Phone:713-442-6920
Practice Address - Fax:713-442-6921
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KS PHARM, LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-06-22
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX34322OtherTEXAS STATE BOARD OF PHARMACY