Organization
KAKS HEALTHCARE, LLC
Active
Organization
KAKS HEALTHCARE, LLC
Active
Other names
Pharm House Drug - La Grange LLC, Pharm House Drug - La Grange, LLC.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KRISTI ANN KUBOSH PHARMD (OWNER)
(979) 218-4735
Entity
Organization
Contact information
Practice address
110 E TRAVIS ST, LA GRANGE, TX 78945-2615
(979) 968-5835
(979) 968-8580
Mailing address
4941 REIGER AVE, DALLAS, TX 75214
(979) 218-4735
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
31766
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149786
—
TX
01
—
2175714
PK
—
Enumeration date
01/31/2018
Last updated
09/21/2022
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