Provider Demographics
NPI:1073323028
Name:FM 1488 PHARMACY LLC
Entity type:Organization
Organization Name:FM 1488 PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:PRACHI
Authorized Official - Middle Name:
Authorized Official - Last Name:PATEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-864-1184
Mailing Address - Street 1:4849 FM 1488 RD STE 1500
Mailing Address - Street 2:
Mailing Address - City:MAGNOLIA
Mailing Address - State:TX
Mailing Address - Zip Code:77354-4560
Mailing Address - Country:US
Mailing Address - Phone:281-864-1184
Mailing Address - Fax:
Practice Address - Street 1:4849 FM 1488 RD STE 1500
Practice Address - Street 2:
Practice Address - City:MAGNOLIA
Practice Address - State:TX
Practice Address - Zip Code:77354-4560
Practice Address - Country:US
Practice Address - Phone:281-864-1184
Practice Address - Fax:281-864-1191
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-11
Last Update Date:2025-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center