Organization
LIFECARE PHARMACY OF AUSTIN LLC
Active
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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