Organization
ACARIAHEALTH PHARMACY 11 INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESSICA CICCOLELLA-KAHL (PRESIDENT)
(855) 422-2742
Entity
Organization
Contact information
Practice address
1311 W SAM HOUSTON PKWY N STE 130, HOUSTON, TX 77043
(800) 511-5144
(866) 834-8523
Mailing address
PO BOX 956780, SAINT LOUIS, MO 63195-6780
(855) 422-2742
(866) 834-8523
Taxonomy
Speciality
Code
Description
License number
State
251F00000X
Home Infusion Agency
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003136163A
—
GA
05
—
0161049
—
OH
05
—
100264790-00
—
NE
05
—
1028435
—
AK
05
—
146690
—
TX
05
—
1629195045
—
IA
05
—
1629195045
—
MN
05
—
194389407
—
AR
05
—
200241760A
—
OK
05
—
200602430A
—
KS
05
—
200921260A
—
IN
01
—
2133868
PK
—
05
—
6031595
—
WA
05
—
709240
—
AZ
05
—
7T5485
—
SC
05
—
86135562
—
NM
05
—
9000143094
—
CO
Enumeration date
03/22/2007
Last updated
02/25/2024
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