Provider Demographics
NPI:1205053519
Name:PHARMCARE L.L.C.
Entity type:Organization
Organization Name:PHARMCARE L.L.C.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:IOANA
Authorized Official - Middle Name:P
Authorized Official - Last Name:BODIU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-996-7500
Mailing Address - Street 1:1834 BROADWAY
Mailing Address - Street 2:SUITE 106
Mailing Address - City:PEARLAND
Mailing Address - State:TX
Mailing Address - Zip Code:77581-5669
Mailing Address - Country:US
Mailing Address - Phone:281-996-7500
Mailing Address - Fax:281-996-7636
Practice Address - Street 1:1834 BROADWAY
Practice Address - Street 2:#106
Practice Address - City:PEARLAND
Practice Address - State:TX
Practice Address - Zip Code:77581-5669
Practice Address - Country:US
Practice Address - Phone:281-996-7500
Practice Address - Fax:281-996-7636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-19
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX24005183500000X
TX22704183500000X
3336C0003X, 3336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX145529Medicaid
TX24005OtherSTATE PHARMACY LICENSE
TX145373Medicaid
TX145373Medicaid
TX145529Medicaid