Organization
MAIN STREET PHARMACY INC
Active
Other names
MAIN STREET PHARMACY INC
Organization subpart
No
Provider details
NPI number
Authorized official
JW LIGON RPH (PHRMD)
(713) 747-6116
Entity
Organization
Contact information
Practice address
12361 MAIN ST, HOUSTON, TX 77035-6200
(713) 729-3800
(713) 729-3837
Mailing address
5611 TALLOW LN, HOUSTON, TX 77021-3216
(713) 747-6116
(713) 741-8429
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
25848
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4547571
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
02/19/2008
Last updated
12/08/2009
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