Provider Demographics
NPI:1457119430
Name:SENATE AVENUE PHARMACY
Entity Type:Organization
Organization Name:SENATE AVENUE PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PIC
Authorized Official - Prefix:DR
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH WILLIAMS
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:210-748-3260
Mailing Address - Street 1:7412 SENATE AVE
Mailing Address - Street 2:
Mailing Address - City:JERSEY VILLAGE
Mailing Address - State:TX
Mailing Address - Zip Code:77040-3044
Mailing Address - Country:US
Mailing Address - Phone:210-748-3260
Mailing Address - Fax:
Practice Address - Street 1:7412 SENATE AVE
Practice Address - Street 2:
Practice Address - City:JERSEY VILLAGE
Practice Address - State:TX
Practice Address - Zip Code:77040-3044
Practice Address - Country:US
Practice Address - Phone:210-748-3260
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-13
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy