Provider Demographics
NPI:1689399362
Name:A 1 PHARMACY
Entity Type:Organization
Organization Name:A 1 PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:936-224-8624
Mailing Address - Street 1:10161 STATE HWY 242
Mailing Address - Street 2:SUITE 130
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77385-4374
Mailing Address - Country:US
Mailing Address - Phone:936-209-3553
Mailing Address - Fax:936-242-1824
Practice Address - Street 1:10161 TX 242
Practice Address - Street 2:SUITE 130
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77385
Practice Address - Country:US
Practice Address - Phone:936-224-5387
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-05
Last Update Date:2024-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX33002OtherSTATE BOARD OF PHARMCY