Provider Demographics
NPI:1255583589
Name:LIFE DRUGS RX LLC
Entity type:Organization
Organization Name:LIFE DRUGS RX LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NAJMUDDIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KARIMJEE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-794-1111
Mailing Address - Street 1:12015 LOUETTA RD STE 300
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77070-1155
Mailing Address - Country:US
Mailing Address - Phone:713-462-7029
Mailing Address - Fax:713-462-5252
Practice Address - Street 1:12015 LOUETTA RD STE 300
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77070-1155
Practice Address - Country:US
Practice Address - Phone:713-462-7029
Practice Address - Fax:713-462-5252
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-17
Last Update Date:2016-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
TX262093336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2117540OtherPK
TX145994Medicaid