Provider Demographics
NPI:1952312548
Name:PARKVIEW PHARMACY INC
Entity Type:Organization
Organization Name:PARKVIEW PHARMACY INC
Other - Org Name:AMEX PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:AVINASH
Authorized Official - Middle Name:
Authorized Official - Last Name:SHIVSHANKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-778-0400
Mailing Address - Street 1:5420 BELLAIRE BLVD
Mailing Address - Street 2:
Mailing Address - City:BELLAIRE
Mailing Address - State:TX
Mailing Address - Zip Code:77401-3957
Mailing Address - Country:US
Mailing Address - Phone:832-778-0400
Mailing Address - Fax:832-778-0404
Practice Address - Street 1:5420 BELLAIRE BLVD
Practice Address - Street 2:
Practice Address - City:BELLAIRE
Practice Address - State:TX
Practice Address - Zip Code:77401-3957
Practice Address - Country:US
Practice Address - Phone:832-778-0400
Practice Address - Fax:832-778-0404
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-10
Last Update Date:2016-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
TX230413336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX148106Medicaid
2096468OtherPK