Organization
CNC PHARMACY COMPOUNDING
Active
Other names
Fairfield Pharmacy / Compounding
Organization subpart
No
Provider details
NPI number
Authorized official
CHIEBONAM ONYEKWELU PHARMD (MANAGING MEMBER)
(281) 827-4432
Entity
Organization
Contact information
Practice address
15040 FAIRFIELD VILLAGE SQUARE DR STE 100, CYPRESS, TX 77433-7900
(281) 758-4040
(281) 758-4043
Mailing address
15040 FAIRFIELD VILLAGE SQUARE DR STE 100, CYPRESS, TX 77433-7900
(281) 758-4040
(281) 758-4043
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
27661
TX
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2132252
PK
—
Enumeration date
09/07/2011
Last updated
03/31/2021
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