Organization
MOUNTAIN CARE PHARMACY HOUSTON LLC
Active
Other names
Mountain Care Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JARED MEMMOTT (DIRECTOR OF COMPLIANCE)
(801) 713-0106
Entity
Organization
Contact information
Practice address
10665 RICHMOND AVE STE 195, HOUSTON, TX 77042-5110
(713) 300-0191
Mailing address
1030 W BELLWOOD LN, SALT LAKE CITY, UT 84123-4494
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
3336S0011X
Specialty Pharmacy
Primary
28722
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2141042
PK
—
Enumeration date
06/21/2013
Last updated
10/26/2013
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