Provider Demographics
NPI:1881857373
Name:ACRES HOME PHARMACY LLC
Entity Type:Organization
Organization Name:ACRES HOME PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:TAMIKA
Authorized Official - Middle Name:S
Authorized Official - Last Name:FORD
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-748-4885
Mailing Address - Street 1:9734 W MONTGOMERY RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77088-4618
Mailing Address - Country:US
Mailing Address - Phone:281-448-5511
Mailing Address - Fax:281-448-5522
Practice Address - Street 1:9734 W MONTGOMERY RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77088-4618
Practice Address - Country:US
Practice Address - Phone:281-448-5511
Practice Address - Fax:281-448-5522
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-06
Last Update Date:2008-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX26011333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy