Organization
AMBER JAR PHARMACY, LLC
Active
Other names
Amber Jar Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
WALAA MOUSSA (OFFICER)
(713) 893-5993
Entity
Organization
Contact information
Practice address
6160 RICHMOND AVE, HOUSTON, TX 77057-6210
(713) 893-5993
(713) 893-5693
Mailing address
6160 RICHMOND AVE, HOUSTON, TX 77057-6210
(713) 893-5993
(713) 893-5693
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28575
TX
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2140998
PK
—
Enumeration date
06/25/2013
Last updated
07/19/2018
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