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Organization
HOSPITAL PHARMACY
Active
Organization
HOSPITAL PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
O HOUSTON (OWNER)
(517) 476-7338
Entity
Organization
Contact information
Practice address
2115 E M L KING BLVD, AUSTIN, TX 78702
(512) 476-7338
(512) 476-7341
Mailing address
2115 E M L KING BLVD, AUSTIN, TX 78702
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
3355
TX
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
130675
—
TX
01
—
4513176
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
12/11/2006
Last updated
09/04/2007
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