Provider Demographics
NPI:1063713386
Name:MEDLINK PHARMACY LLC
Entity type:Organization
Organization Name:MEDLINK PHARMACY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST-IN-CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:AKWASI
Authorized Official - Middle Name:
Authorized Official - Last Name:AMANKWAAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-752-8800
Mailing Address - Street 1:1570 S DAIRY ASHFORD ST STE 115
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77077-3862
Mailing Address - Country:US
Mailing Address - Phone:281-752-8800
Mailing Address - Fax:281-752-8811
Practice Address - Street 1:1570 S DAIRY ASHFORD ST STE 115
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77077-3862
Practice Address - Country:US
Practice Address - Phone:281-752-8800
Practice Address - Fax:281-752-8811
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-03
Last Update Date:2010-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
3336C0003X
TX27246333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
5901752OtherNCPDP PROVIDER IDENTIFICATION NUMBER