Provider Demographics
NPI:1295592384
Name:CBL PHARMACY LLC
Entity type:Organization
Organization Name:CBL PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:VIVIAN
Authorized Official - Middle Name:
Authorized Official - Last Name:ABOBO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-478-9601
Mailing Address - Street 1:11242 FM 1960 RD W STE 106
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77065-3635
Mailing Address - Country:US
Mailing Address - Phone:832-478-9601
Mailing Address - Fax:832-478-9608
Practice Address - Street 1:11242 FM 1960 RD W STE 106
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77065-3635
Practice Address - Country:US
Practice Address - Phone:832-478-9601
Practice Address - Fax:832-478-9608
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-05
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy