Provider Demographics
NPI:1982841722
Name:MAX PHARMACY INC
Entity Type:Organization
Organization Name:MAX PHARMACY INC
Other - Org Name:MAX PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KAWN
Authorized Official - Middle Name:H
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-373-9944
Mailing Address - Street 1:17074 HIGHWAY 3
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:TX
Mailing Address - Zip Code:77598-4129
Mailing Address - Country:US
Mailing Address - Phone:713-373-9944
Mailing Address - Fax:713-697-1609
Practice Address - Street 1:17074 HIGHWAY 3
Practice Address - Street 2:
Practice Address - City:WEBSTER
Practice Address - State:TX
Practice Address - Zip Code:77598-4129
Practice Address - Country:US
Practice Address - Phone:713-373-9944
Practice Address - Fax:713-697-1609
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-15
Last Update Date:2009-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX263053336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX26305OtherTX PHARMACY LICENSE