Organization
BNC PHARMACY LLC
Active
Other names
LIFEMED PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
CHIDEBEM NWOSU (MANG)
(713) 773-3800
Entity
Organization
Contact information
Practice address
6565 DEMOSS, STE 104C, HOUSTON, TX 77074
(713) 773-3800
(713) 773-3865
Mailing address
6565 DEMOSS, STE 104C, HOUSTON, TX 77074
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
25931
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4547800
OTHER ID NUMBER
—
Enumeration date
03/14/2008
Last updated
03/21/2008
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