Provider Demographics
NPI:1336444256
Name:OBATARE AVWORO LLC
Entity Type:Organization
Organization Name:OBATARE AVWORO LLC
Other - Org Name:A PLUS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER / PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:OBATARE
Authorized Official - Middle Name:RICHARD
Authorized Official - Last Name:AVWORO
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:346-352-4930
Mailing Address - Street 1:10301 HARWIN DR STE 3
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77036-2793
Mailing Address - Country:US
Mailing Address - Phone:346-352-4930
Mailing Address - Fax:346-352-4959
Practice Address - Street 1:10301 HARWIN DR STE 3
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77036-2793
Practice Address - Country:US
Practice Address - Phone:346-352-4930
Practice Address - Fax:346-352-4959
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-25
Last Update Date:2020-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336H0001X, 3336L0003X
TX273403336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Yes333600000XSuppliersPharmacy
No3336H0001XSuppliersPharmacyHome Infusion Therapy Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5902362OtherNCPDP PROVIDER IDENTIFICATION NUMBER