Organization
NORTH SHORE PHARMACY LLC
Active
Other names
North Shore Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB LEWIS (PHARMACIST-IN-CHARGE/OWNER)
(505) 710-3471
Entity
Organization
Contact information
Practice address
113 STARGRASS STE 100, SPRING BRANCH, TX 78070-5165
(830) 214-2920
(830) 935-4532
Mailing address
113 STARGRASS, SUITE 100, SPRING BRANCH, TX 78070-5164
(830) 214-2920
(830) 935-4532
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28640
TX
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2139811
PK
—
Enumeration date
04/10/2013
Last updated
03/17/2017
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