Provider Demographics
NPI:1912412297
Name:GLP3 PHARMACY
Entity Type:Organization
Organization Name:GLP3 PHARMACY
Other - Org Name:GOOD LIFE PHARMACY #3
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:STAUDT
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:830-214-2920
Mailing Address - Street 1:113 STARGRASS STE 100
Mailing Address - Street 2:
Mailing Address - City:SPRING BRANCH
Mailing Address - State:TX
Mailing Address - Zip Code:78070-5165
Mailing Address - Country:US
Mailing Address - Phone:830-214-2920
Mailing Address - Fax:830-935-4532
Practice Address - Street 1:113 STARGRASS STE 100
Practice Address - Street 2:
Practice Address - City:SPRING BRANCH
Practice Address - State:TX
Practice Address - Zip Code:78070-5165
Practice Address - Country:US
Practice Address - Phone:830-214-2920
Practice Address - Fax:830-935-4532
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-07
Last Update Date:2018-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy