Organization
LIFECARE PHARMACY OF AUSTIN LLC
Active
Other names
Lifecare Pharmacy of Austin
Organization subpart
No
Provider details
NPI number
Authorized official
PREM KALIDINDI (OWNER, AO)
(917) 769-8014
Entity
Organization
Contact information
Practice address
3110 NOGALITOS STE 107, SAN ANTONIO, TX 78225-2337
(210) 600-3282
(210) 549-4002
Mailing address
3110 NOGALITOS STE 107, SAN ANTONIO, TX 78225-2337
(210) 600-3282
(210) 549-4002
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
31065
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149546
—
TX
01
—
2165949
PK
—
Enumeration date
11/01/2016
Last updated
09/22/2020
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