Organization
KS PHARM LLC
Active
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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