Organization
NORTHEAST COMPOUNDING PHCY LP
Active
Other names
THRIFTY HLTH AND COMPOUNDING PHCY
Organization subpart
No
Provider details
NPI number
Authorized official
TERRY MIELKE RPH (PIC)
(281) 446-9191
Entity
Organization
Contact information
Practice address
211 FM 1960 BYPASS RD E, HUMBLE, TX 77338-3605
(281) 446-9191
(281) 446-2329
Mailing address
211 FM 1960 BYPASS RD E, HUMBLE, TX 77338-3605
(281) 446-9191
(281) 446-2329
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
21404
TX
3336C0004X
Compounding Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
145193 TX
—
TX
01
—
4563133
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
03/02/2007
Last updated
12/15/2011
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