Organization
GREEN LEAF PHARMACY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL KIIGI (MANAGER)
(469) 795-9060
Entity
Organization
Contact information
Practice address
201 W BOYD DR STE 105A, ALLEN, TX 75013-2512
(682) 410-0002
Mailing address
201 W BOYD DR STE 105A, ALLEN, TX 75013-2512
(682) 410-0002
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
32842
TEXAS STATE BOARD OF PHARMACY
TX
Enumeration date
09/17/2019
Last updated
05/20/2020
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