Organization
FARMACIA DE MEDICIA INC
Active
Other names
MASTERY PHARMACY SOUTH
Organization subpart
No
Provider details
NPI number
Authorized official
CEDRIC WASHINGTON CPHT (PRESIDENT)
(281) 330-5044
Entity
Organization
Contact information
Practice address
2715 FANNIN ST, HOUSTON, TX 77002-9217
(713) 838-8110
(713) 838-8797
Mailing address
2715 FANNIN ST, HOUSTON, TX 77002-9217
(713) 838-8110
(713) 838-8797
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
23660
TX
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
145457
—
TX
01
—
2090578
PK
—
Enumeration date
10/07/2006
Last updated
06/10/2015
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