Provider Demographics
NPI:1760069223
Name:DUMDIETER PHARMACY LLC
Entity Type:Organization
Organization Name:DUMDIETER PHARMACY LLC
Other - Org Name:DUMDIETER PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JORGE
Authorized Official - Middle Name:LUIS
Authorized Official - Last Name:RAMIREZ ORTEGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-207-7575
Mailing Address - Street 1:2047 W MAIN STREET
Mailing Address - Street 2:SUITE A-10
Mailing Address - City:LEAGUE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77573
Mailing Address - Country:US
Mailing Address - Phone:281-207-7575
Mailing Address - Fax:281-207-7575
Practice Address - Street 1:2047 W MAIN STREET
Practice Address - Street 2:SUITE A-10
Practice Address - City:LEAGUE CITY
Practice Address - State:TX
Practice Address - Zip Code:77573
Practice Address - Country:US
Practice Address - Phone:281-207-7575
Practice Address - Fax:281-207-7575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-29
Last Update Date:2021-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy