Provider Demographics
NPI:1881182673
Name:NALZ CORPORATION
Entity Type:Organization
Organization Name:NALZ CORPORATION
Other - Org Name:COMET SPECIALTY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:GHEBREMICHAEL
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:281-520-5367
Mailing Address - Street 1:5420 DASHWOOD DR STE 201
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77081-5332
Mailing Address - Country:US
Mailing Address - Phone:346-406-5095
Mailing Address - Fax:346-406-5096
Practice Address - Street 1:5420 DASHWOOD DR STE 201
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77081-5332
Practice Address - Country:US
Practice Address - Phone:346-406-5095
Practice Address - Fax:346-406-5096
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-04-26
Last Update Date:2020-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX149904Medicaid