Organization
MARINA BAY PHARMACY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHANNA LAZANO (CORPORATE OFFICER)
(832) 932-3696
Entity
Organization
Contact information
Practice address
1416 E MAIN ST STE C, LEAGUE CITY, TX 77573-4153
(832) 932-3696
(832) 932-3697
Mailing address
1416 E MAIN ST STE C, LEAGUE CITY, TX 77573-4153
(832) 932-3696
(832) 932-3697
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
03/26/2020
Last updated
03/21/2021
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