Provider Demographics
NPI:1104606557
Name:DCP HEALTH LLC
Entity type:Organization
Organization Name:DCP HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MIRAMONTES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:346-314-4903
Mailing Address - Street 1:340 PAN AMERICAN DR STE B5B
Mailing Address - Street 2:
Mailing Address - City:LIVINGSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77351-4000
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:340 PAN AMERICAN DR STE B5B
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:TX
Practice Address - Zip Code:77351-4000
Practice Address - Country:US
Practice Address - Phone:936-221-5622
Practice Address - Fax:281-754-4361
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-03
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy