Provider Demographics
NPI:1841211810
Name:ZAIN LLC
Entity Type:Organization
Organization Name:ZAIN LLC
Other - Org Name:COLLEGE PARK PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ZARMEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:KHAN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:917-656-7568
Mailing Address - Street 1:3115 COLLEGE PARK DR
Mailing Address - Street 2:STE 103A
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77384
Mailing Address - Country:US
Mailing Address - Phone:936-321-4011
Mailing Address - Fax:936-273-9008
Practice Address - Street 1:3115 COLLEGE PARK DR
Practice Address - Street 2:STE 103A
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77384
Practice Address - Country:US
Practice Address - Phone:936-321-4011
Practice Address - Fax:936-273-9008
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2018-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336L0003X
TX271593336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX148315Medicaid
2126666OtherPK
TX7458550001Medicare NSC
TX5649360001Medicare NSC