Provider Demographics
NPI:1013499797
Name:MK PHARMACY,LLC
Entity Type:Organization
Organization Name:MK PHARMACY,LLC
Other - Org Name:MK PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:MALAK
Authorized Official - Middle Name:
Authorized Official - Last Name:KHOUDAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:713-269-6579
Mailing Address - Street 1:14419 TIVOLI DR
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-1046
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:18006 PARK ROW DR
Practice Address - Street 2:SUITE 350
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77084
Practice Address - Country:US
Practice Address - Phone:713-269-6579
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-08-30
Last Update Date:2018-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXIFROW1400OtherHIN