Provider Demographics
NPI:1942788336
Name:PHARMACY INVESTMENT ASSOCIATES LLC
Entity Type:Organization
Organization Name:PHARMACY INVESTMENT ASSOCIATES LLC
Other - Org Name:ABANA HEALTH PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:PRAMODKUMAR
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAHIWALA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:936-267-2979
Mailing Address - Street 1:3301 W DAVIS ST STE F
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-1872
Mailing Address - Country:US
Mailing Address - Phone:936-267-2979
Mailing Address - Fax:936-267-2998
Practice Address - Street 1:3301 W DAVIS ST STE F
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-1872
Practice Address - Country:US
Practice Address - Phone:936-267-2979
Practice Address - Fax:936-267-2998
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-30
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX320313336C0003X
3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX32031OtherTEXAS STATE BOARD OF PHARMACY
TXFA7587390OtherDRUG ENFORCEMENT ADMINISTRATION