Provider Demographics
NPI:1952819724
Name:NEXTCARE PHARMACY, LLC
Entity Type:Organization
Organization Name:NEXTCARE PHARMACY, LLC
Other - Org Name:NEXTCARE PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMILTON
Authorized Official - Suffix:
Authorized Official - Credentials:DPH, RPH
Authorized Official - Phone:936-203-8499
Mailing Address - Street 1:10021 MAIN ST STE B-2A
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77025-5224
Mailing Address - Country:US
Mailing Address - Phone:713-492-2088
Mailing Address - Fax:713-554-0425
Practice Address - Street 1:10021 MAIN ST STE B-2A
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77025
Practice Address - Country:US
Practice Address - Phone:713-492-2088
Practice Address - Fax:713-554-0425
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-01-16
Last Update Date:2020-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
TX312183336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2175333OtherPK