Organization
PHS SUC PHARMACY LLC
Active
Other names
PHS SUC Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
COURTNEY DIAZ (MANAGING PARTNER)
(832) 916-4674
Entity
Organization
Contact information
Practice address
624 W MAIN ST STE 101, LEAGUE CITY, TX 77573-3890
(832) 916-4674
Mailing address
624 W MAIN ST STE 101, LEAGUE CITY, TX 77573-3890
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
09/16/2020
Last updated
09/16/2020
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