Organization
KS PHARM LLC
Active
Other names
Kelsey Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
LANCE AARON JORDAN R.PH (DIRECTOR OF PHARMACY)
(713) 442-5251
Entity
Organization
Contact information
Practice address
106 VISION PARK BLVD, SHENANDOAH, TX 77384
(713) 442-1975
(713) 442-1995
Mailing address
106 VISION PARK BLVD, SHENANDOAH, TX 77384
(713) 442-1975
(713) 442-1995
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4532594
OTHER ID NUMBER-COMMERCIAL NUMBER
—
05
—
470967
—
TX
Enumeration date
12/13/2006
Last updated
03/15/2024
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