Provider Demographics
NPI:1821551193
Name:SUPERFAST PHARMACY AND MEDICAL SUPPLIES LLC
Entity Type:Organization
Organization Name:SUPERFAST PHARMACY AND MEDICAL SUPPLIES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER OF LLC
Authorized Official - Prefix:
Authorized Official - First Name:PRACHI
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-513-7960
Mailing Address - Street 1:228 DOVE MEADOW DR
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77384-1416
Mailing Address - Country:US
Mailing Address - Phone:281-513-7960
Mailing Address - Fax:
Practice Address - Street 1:11690 SPRING CYPRESS RD STE 100
Practice Address - Street 2:
Practice Address - City:TOMBALL
Practice Address - State:TX
Practice Address - Zip Code:77377-8938
Practice Address - Country:US
Practice Address - Phone:281-513-7960
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-04-12
Last Update Date:2019-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy