Organization
FM 1488 PHARMACY LLC
Active
Other names
FM 1488 PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
PRACHI K PATEL (MANAGING OFFICER/OWNER)
(281) 864-1184
Entity
Organization
Contact information
Practice address
4849 FM 1488 RD STE 1500, THE WOODLANDS, TX 77354-4560
(281) 864-1184
(281) 864-1191
Mailing address
4849 FM 1488 RD STE 1500, THE WOODLANDS, TX 77354-4560
(281) 864-1184
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
3336M0002X
Mail Order Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
150562
—
TX
Enumeration date
07/13/2022
Last updated
10/31/2023
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