Organization
PHOENIX DRUGSTORE & MEDICAL SUPPLIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PATRICE W CLIFFORD PHARM.D (PHARMACIST-IN-CHARGE/OWNER)
(713) 302-5773
Entity
Organization
Contact information
Practice address
17320 RED OAK DR STE 106, HOUSTON, TX 77090-2633
(832) 446-6014
(832) 446-6018
Mailing address
20735 FAWN TIMBER TRL, HUMBLE, TX 77346-3891
(832) 446-6014
(832) 446-6018
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
3336M0002X
Mail Order Pharmacy
—
—
Other
Enumeration date
12/19/2018
Last updated
10/19/2020
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