Provider Demographics
NPI:1932463122
Name:AIRLINE PHARMACY ASSOCIATES LLC
Entity Type:Organization
Organization Name:AIRLINE PHARMACY ASSOCIATES LLC
Other - Org Name:AIRLINE PHARMACY ASSOCIATES, L.L.C.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:ADMIN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSE
Authorized Official - Middle Name:
Authorized Official - Last Name:GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-447-1375
Mailing Address - Street 1:11012 AIRLINE DR STE A
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77037-1112
Mailing Address - Country:US
Mailing Address - Phone:281-354-5036
Mailing Address - Fax:281-667-3275
Practice Address - Street 1:24420 FM 1314 RD STE 8
Practice Address - Street 2:
Practice Address - City:PORTER
Practice Address - State:TX
Practice Address - Zip Code:77365-5490
Practice Address - Country:US
Practice Address - Phone:281-354-5036
Practice Address - Fax:281-667-3275
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-02
Last Update Date:2013-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX284103336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5906435OtherNCPDP PROVIDER IDENTIFICATION NUMBER