Provider Demographics
NPI:1194430892
Name:AGERITE PHARMACY LLC
Entity type:Organization
Organization Name:AGERITE PHARMACY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CINDY
Authorized Official - Middle Name:
Authorized Official - Last Name:AMAKWE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD, MS
Authorized Official - Phone:832-786-9084
Mailing Address - Street 1:12827 TELGE RD
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77429-4102
Mailing Address - Country:US
Mailing Address - Phone:832-786-9084
Mailing Address - Fax:
Practice Address - Street 1:12827 TELGE RD
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77429-4102
Practice Address - Country:US
Practice Address - Phone:832-786-9084
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-17
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0004XSuppliersPharmacyCompounding Pharmacy
No333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy