Provider Demographics
NPI:1932896362
Name:SAMLENAPETER LLC.
Entity type:Organization
Organization Name:SAMLENAPETER LLC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PIC
Authorized Official - Prefix:DR
Authorized Official - First Name:AGNES
Authorized Official - Middle Name:H
Authorized Official - Last Name:LEE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:936-693-2506
Mailing Address - Street 1:3251 INTERSTATE 45 N STE 190
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77304-2185
Mailing Address - Country:US
Mailing Address - Phone:936-693-2506
Mailing Address - Fax:844-333-3069
Practice Address - Street 1:3251 INTERSTATE 45 N STE 190
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77304-2185
Practice Address - Country:US
Practice Address - Phone:310-346-9780
Practice Address - Fax:844-333-0369
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-18
Last Update Date:2023-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy