Provider Demographics
NPI:1720638703
Name:TULIP PHARMACY LLC
Entity Type:Organization
Organization Name:TULIP PHARMACY LLC
Other - Org Name:TULIP PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:KEITH
Authorized Official - Middle Name:WENDELL
Authorized Official - Last Name:HAMPTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:346-843-2294
Mailing Address - Street 1:1020 HERNDON DR.
Mailing Address - Street 2:
Mailing Address - City:ROSENBERG
Mailing Address - State:TX
Mailing Address - Zip Code:77471
Mailing Address - Country:US
Mailing Address - Phone:346-843-2294
Mailing Address - Fax:832-218-8477
Practice Address - Street 1:1020 HERNDON DR.
Practice Address - Street 2:
Practice Address - City:ROSENBERG
Practice Address - State:TX
Practice Address - Zip Code:77471
Practice Address - Country:US
Practice Address - Phone:346-843-2294
Practice Address - Fax:832-218-8477
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:TULIP PHARMACY LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-09-12
Last Update Date:2021-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy