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Organization

MAVIS O PHARMACY LLC

Active
Other names
Mavis O Pharmacy
Organization subpart
No

Provider details

NPI number
Authorized official
BAYO ADENIYI (PIC)
(281) 498-1161
Entity
Organization

Contact information

Practice address
10080 BELLAIRE BLVD STE 102, HOUSTON, TX 77072-5249
(281) 498-1161
(281) 498-1180
Mailing address
10080 BELLAIRE BLVD STE 102, HOUSTON, TX 77072-5249
(281) 498-1161
(281) 498-1180

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
27514
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2130938
PK
Enumeration date
06/24/2011
Last updated
09/04/2015
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