Provider Demographics
NPI:1982227740
Name:DULIVUTO CORP INC
Entity Type:Organization
Organization Name:DULIVUTO CORP INC
Other - Org Name:FRIENDSWOOD HEALTH MART PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LONG
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-315-1300
Mailing Address - Street 1:4606 FM 1960 RD W STE 250
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77069-4617
Mailing Address - Country:US
Mailing Address - Phone:281-315-1300
Mailing Address - Fax:281-315-1302
Practice Address - Street 1:4606 FM 1960 RD W STE 250
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77069-4617
Practice Address - Country:US
Practice Address - Phone:281-315-1300
Practice Address - Fax:281-315-1302
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-05-27
Last Update Date:2023-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336M0002XSuppliersPharmacyMail Order Pharmacy