Provider Demographics
NPI:1063977452
Name:ALDINE FAMILY PHARMACY
Entity type:Organization
Organization Name:ALDINE FAMILY PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:GERALD
Authorized Official - Middle Name:
Authorized Official - Last Name:ZIMMERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:281-303-5859
Mailing Address - Street 1:2345 ALDINE MAIL RTE STE A
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77039-5528
Mailing Address - Country:US
Mailing Address - Phone:281-303-5859
Mailing Address - Fax:
Practice Address - Street 1:2345 ALDINE MAIL RTE STE A
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77039-5528
Practice Address - Country:US
Practice Address - Phone:281-303-5859
Practice Address - Fax:281-741-9407
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-02-10
Last Update Date:2019-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy