Provider Demographics
NPI:1699297051
Name:YOUR HEALTH PHARMACY
Entity type:Organization
Organization Name:YOUR HEALTH PHARMACY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:OKWUCHI
Authorized Official - Middle Name:VIVIAN
Authorized Official - Last Name:ADODO
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:718-844-3203
Mailing Address - Street 1:4506 FERNDALE MEADOWS DR
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77494-5334
Mailing Address - Country:US
Mailing Address - Phone:718-844-3203
Mailing Address - Fax:
Practice Address - Street 1:477 W PARKER RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77091-3202
Practice Address - Country:US
Practice Address - Phone:718-844-3203
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-07
Last Update Date:2017-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy