Organization
ECKERDS RX 106 LLC
Active
Other names
ECKERDS PHARMACY 106
Organization subpart
No
Provider details
NPI number
Authorized official
MR. VIKRAM BACHUBHAI RAO BPHARM (PRESIDENT)
(941) 524-6545
Entity
Organization
Contact information
Practice address
120 CIRCLE WAY ST STE 7F, LAKE JACKSON, TX 77566-5222
(979) 341-9811
(979) 341-9822
Mailing address
120 CIRCLE WAY ST STE 7F, LAKE JACKSON, TX 77566-5222
(979) 341-9811
(979) 341-9822
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
32186
TX
333600000X
Pharmacy
32186
TX
3336C0003X
Community/Retail Pharmacy
Primary
32186
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149901
—
TX
01
—
32186
BOARD OF PHARMACY
TX
Enumeration date
08/03/2018
Last updated
02/16/2022
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