Organization
PR PHARMACY
Active
Organization
PR PHARMACY
Active
Other names
PR PHARMACY LLC
Organization subpart
No
Provider details
NPI number
Authorized official
MARIAMMA KALATHIL (OWNER)
(832) 605-4329
Entity
Organization
Contact information
Practice address
5819 HIGHWAY 6 STE 160, MISSOURI CITY, TX 77459-4069
(832) 230-8027
(832) 230-8676
Mailing address
5819 HIGHWAY 6 STE 160, MISSOURI CITY, TX 77459-4069
(832) 230-8027
(832) 230-8676
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28039
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5906396
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
07/18/2012
Last updated
07/18/2012
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