Organization
CKW SQUARED LLC
Active
Other names
Main Stop RX
Organization subpart
No
Provider details
NPI number
Authorized official
KELLIE POTTS (OWNER)
(713) 721-4040
Entity
Organization
Contact information
Practice address
14585 MAIN ST, HOUSTON, TX 77035-6560
(713) 721-4040
(713) 721-1717
Mailing address
14585 MAIN ST, HOUSTON, TX 77035-6560
(713) 721-4040
(713) 721-1717
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
26821
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4555251
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
03/10/2010
Last updated
05/26/2011
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