Provider Demographics
NPI:1194244020
Name:SPRING GREEN PHARMACY
Entity type:Organization
Organization Name:SPRING GREEN PHARMACY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HARSH
Authorized Official - Middle Name:
Authorized Official - Last Name:VARDHAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:281-942-4330
Mailing Address - Street 1:1443 FM 1463 RD STE 650
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-5479
Mailing Address - Country:US
Mailing Address - Phone:281-942-4330
Mailing Address - Fax:281-665-8891
Practice Address - Street 1:1443 FM 1463 RD STE 650
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77494-5479
Practice Address - Country:US
Practice Address - Phone:281-942-4330
Practice Address - Fax:281-665-8891
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX310273336L0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy