Organization
MAIN STREET PHARMACY INC
Active
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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