Organization
LIFEFOUNTAIN PHARMACY CORP
Active
Other names
Choice Specialty Pharmacy 11
Organization subpart
No
Provider details
NPI number
Authorized official
HARISH GANDHI (OFFICER)
(346) 309-4800
Entity
Organization
Contact information
Practice address
8850 SIX PINES DR STE 150, THE WOODLANDS, TX 77380-2688
(346) 309-4800
(832) 616-3489
Mailing address
8850 SIX PINES DR STE 150, THE WOODLANDS, TX 77380-2688
(346) 309-4800
(832) 616-3489
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
28958
TX
3336C0004X
Compounding Pharmacy
—
—
3336H0001X
Home Infusion Therapy Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
149870
—
TX
01
—
2144018
PK
—
Enumeration date
01/24/2014
Last updated
06/16/2025
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