Provider Demographics
NPI:1730495961
Name:ACP OF THE WOODLANDS, LLC
Entity Type:Organization
Organization Name:ACP OF THE WOODLANDS, LLC
Other - Org Name:ASSURANCE CONSOLIDATED PHARMACY OF THE WOODLANDS, LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:LATOSHA
Authorized Official - Middle Name:C
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:832-813-8199
Mailing Address - Street 1:26202 OAK RIDGE DR.
Mailing Address - Street 2:STE. A-102
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77380-4301
Mailing Address - Country:US
Mailing Address - Phone:832-813-8199
Mailing Address - Fax:832-813-8949
Practice Address - Street 1:26202 OAK RIDGE DR.
Practice Address - Street 2:STE. A-102
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77380-4301
Practice Address - Country:US
Practice Address - Phone:832-813-8199
Practice Address - Fax:832-813-8949
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-25
Last Update Date:2018-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336C0003X, 3336C0004X
TX289033336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2144611OtherPK