Organization
PROVIDENCE PHARMACY & MEDICAL SUPPLIES, INC.
Active
Other names
PROVIDENCE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
EMMANUEL ORUSAKWE (PRESIDENT)
(832) 623-7554
Entity
Organization
Contact information
Practice address
9525 BISSONNET ST STE 250, HOUSTON, TX 77036-8028
(832) 623-7554
(832) 832-5693
Mailing address
9525 BISSONNET ST STE 250, HOUSTON, TX 77036-8028
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
11/07/2018
Last updated
11/07/2018
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