Provider Demographics
NPI:1689450116
Name:NOVA HEALTH PHARMACY LLC
Entity Type:Organization
Organization Name:NOVA HEALTH PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PHARMACY
Authorized Official - Prefix:
Authorized Official - First Name:JOLENE
Authorized Official - Middle Name:
Authorized Official - Last Name:BURTON
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:281-465-1767
Mailing Address - Street 1:8845 SIX PINES DR STE 200
Mailing Address - Street 2:
Mailing Address - City:SHENANDOAH
Mailing Address - State:TX
Mailing Address - Zip Code:77380-4296
Mailing Address - Country:US
Mailing Address - Phone:281-465-1767
Mailing Address - Fax:281-298-3367
Practice Address - Street 1:22751 PROFESSIONAL DR STE 140
Practice Address - Street 2:
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-6024
Practice Address - Country:US
Practice Address - Phone:713-595-8116
Practice Address - Fax:281-699-5062
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-31
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy