Organization
EAST FREEWAY PHARMACY LLC
Active
Organization
EAST FREEWAY PHARMACY LLC
Active
Other names
East Freeway Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
PRESTON FONTENOT (OWNER)
(713) 637-7697
Entity
Organization
Contact information
Practice address
12322 EAST FWY STE B1, HOUSTON, TX 77015-5538
(713) 637-7697
(713) 637-7698
Mailing address
12322 EAST FWY STE B1, HOUSTON, TX 77015-5538
(713) 637-7697
(713) 637-7698
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
27544
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5903857
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
07/11/2011
Last updated
02/05/2013
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