Provider Demographics
NPI:1932708609
Name:DEHEALTH LINE LLC
Entity Type:Organization
Organization Name:DEHEALTH LINE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:COO
Authorized Official - Prefix:
Authorized Official - First Name:GLORIA
Authorized Official - Middle Name:O
Authorized Official - Last Name:EGBUCHUNAM
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:713-541-6000
Mailing Address - Street 1:PO BOX 571854
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77257-1854
Mailing Address - Country:US
Mailing Address - Phone:713-724-1168
Mailing Address - Fax:713-541-6001
Practice Address - Street 1:13910 LEXINGTON BLVD
Practice Address - Street 2:
Practice Address - City:SUGAR LAND
Practice Address - State:TX
Practice Address - Zip Code:77478-5362
Practice Address - Country:US
Practice Address - Phone:713-541-6000
Practice Address - Fax:713-541-6001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-22
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy