Provider Demographics
NPI:1245344233
Name:ADVANTAGES PHARMACY
Entity type:Organization
Organization Name:ADVANTAGES PHARMACY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SPRADLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-359-3892
Mailing Address - Street 1:8901 FM 1960 BYPASS RD W
Mailing Address - Street 2:STE 103
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77338-4018
Mailing Address - Country:US
Mailing Address - Phone:281-359-3892
Mailing Address - Fax:281-359-2654
Practice Address - Street 1:22999 HIGHWAY 59 N
Practice Address - Street 2:STE 142
Practice Address - City:KINGWOOD
Practice Address - State:TX
Practice Address - Zip Code:77339-4412
Practice Address - Country:US
Practice Address - Phone:281-359-3892
Practice Address - Fax:281-359-2654
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2016-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX170463336S0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336S0011XSuppliersPharmacySpecialty Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2099195OtherPK