Provider Demographics
NPI:1265730352
Name:SURE HEALTHCARE PHARMACY
Entity type:Organization
Organization Name:SURE HEALTHCARE PHARMACY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:IKECHUKWU
Authorized Official - Middle Name:
Authorized Official - Last Name:OGUJIOFOR
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-440-0680
Mailing Address - Street 1:PO BOX 73174
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77273-3174
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:921 FM 1960 RD W STE 104A
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77090-2529
Practice Address - Country:US
Practice Address - Phone:281-440-0680
Practice Address - Fax:206-279-9142
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-03-14
Last Update Date:2011-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX273163336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5902766OtherNCPDP PROVIDER IDENTIFICATION NUMBER