Organization
THE KG GROUP LLC
Active
Organization
THE KG GROUP LLC
Active
Other names
Shadow Creek Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
KWAME ALBERT (OWNER)
(832) 617-8080
Entity
Organization
Contact information
Practice address
11710 BROADWAY ST STE 120, PEARLAND, TX 77584-4046
(832) 617-8080
(832) 717-2391
Mailing address
11408 EASTON SPRINGS DR, PEARLAND, TX 77584-2518
(281) 303-7551
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2176871
PK
—
Enumeration date
03/28/2018
Last updated
05/21/2019
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