Provider Demographics
NPI:1972614006
Name:EMPIRICAL PHARMACY LLC
Entity Type:Organization
Organization Name:EMPIRICAL PHARMACY LLC
Other - Org Name:EMPIRICAL PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHCY MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:
Authorized Official - Last Name:EJEKUTE OBI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-480-1470
Mailing Address - Street 1:11030 KINGSPOINT RD STE 6
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77075-4102
Mailing Address - Country:US
Mailing Address - Phone:713-991-0072
Mailing Address - Fax:713-991-0320
Practice Address - Street 1:11030 KINGSPOINT RD STE 6
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77075-4102
Practice Address - Country:US
Practice Address - Phone:713-991-0072
Practice Address - Fax:713-991-0320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-31
Last Update Date:2023-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
TX252973336C0003X, 3336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2099665OtherPK