Provider Demographics
NPI:1720457518
Name:PRO SCRIPT SOLUTIONS PHARMACY, LLC
Entity Type:Organization
Organization Name:PRO SCRIPT SOLUTIONS PHARMACY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MR
Authorized Official - First Name:KIETRICH
Authorized Official - Middle Name:T
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:SR
Authorized Official - Credentials:PHARM D
Authorized Official - Phone:713-206-9069
Mailing Address - Street 1:6730 ATASCOCITA RD
Mailing Address - Street 2:SUITE 111
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77346-1993
Mailing Address - Country:US
Mailing Address - Phone:281-570-6707
Mailing Address - Fax:281-318-7554
Practice Address - Street 1:6730 ATASCOCITA RD
Practice Address - Street 2:SUITE 111
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77346-1993
Practice Address - Country:US
Practice Address - Phone:281-570-6707
Practice Address - Fax:281-318-7554
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-09-22
Last Update Date:2015-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy