Provider Demographics
NPI:1265045751
Name:HOMECARE PHARMACY LLC
Entity type:Organization
Organization Name:HOMECARE PHARMACY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:DR
Authorized Official - First Name:GORATHY
Authorized Official - Middle Name:MARIA
Authorized Official - Last Name:UWAKE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:281-409-0996
Mailing Address - Street 1:8700 S BRAESWOOD BLVD STE B2
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77031-1338
Mailing Address - Country:US
Mailing Address - Phone:832-831-9357
Mailing Address - Fax:346-319-3746
Practice Address - Street 1:8700 S BRAESWOOD BLVD STE B2
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77031-1338
Practice Address - Country:US
Practice Address - Phone:832-831-9357
Practice Address - Fax:346-319-3745
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HOMECARE PHARMACY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-08-25
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX150354Medicaid
TX33379OtherTEXAS BOARD OF PHARMACY