Provider Demographics
NPI:1912632415
Name:IPHARMACY
Entity Type:Organization
Organization Name:IPHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MANAGING OFFICER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TYESHA
Authorized Official - Middle Name:
Authorized Official - Last Name:WASHINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:346-754-5175
Mailing Address - Street 1:11104 W AIRPORT BLVD STE 141
Mailing Address - Street 2:
Mailing Address - City:STAFFORD
Mailing Address - State:TX
Mailing Address - Zip Code:77477-3040
Mailing Address - Country:US
Mailing Address - Phone:346-754-5175
Mailing Address - Fax:
Practice Address - Street 1:11104 W AIRPORT BLVD STE 141
Practice Address - Street 2:
Practice Address - City:STAFFORD
Practice Address - State:TX
Practice Address - Zip Code:77477-3040
Practice Address - Country:US
Practice Address - Phone:346-754-5175
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-19
Last Update Date:2024-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy