Organization
SLG PHARMACY LLC
Active
Other names
Laurel Heights Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
PREM KALIDINDI RPH (MANAGING MEMBER)
(210) 881-0890
Entity
Organization
Contact information
Practice address
2602 N MAIN AVE, SAN ANTONIO, TX 78212-2919
(210) 881-0890
(210) 569-6464
Mailing address
PO BOX 12929, SAN ANTONIO, TX 78212-0929
(917) 769-8014
Taxonomy
Speciality
Code
Description
License number
State
3336S0011X
Specialty Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
146440
—
TX
Enumeration date
10/24/2018
Last updated
10/24/2018
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