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JERSEY VILLAGE PHARMACY LLC NPI 1396172128


NPI Information

NPI: 1396172128
Provider Name: JERSEY VILLAGE PHARMACY LLC

Doing Business As: JERSEY VILLAGE PHARMACY-COMPOUNDING

Classification: Pharmacy - 3336C0004X
Entity Type: Organization

Specialization: Compounding Pharmacy

Address:
17400 HIGHWAY 290 STE 400
JERSEY VILLAGE, TX
ZIP 77040
Phone: (281) 416-5800
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JERSEY VILLAGE PHARMACY LLC is a compounding pharmacy pharmacy in Jersey Village, TX. The provider is a pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner's Prescription Drug Order or initiative based on the Practitioner/Patient/Pharmacist relationship in the course of professional practice. A compounding pharmacy utilizes specialized equipment and specially designed facilities necessary to meet the legal and quality requirements of its scope of compounding practice. JERSEY VILLAGE PHARMACY LLC NPI is 1396172128. The provider is registered as an organization entity type.
The provider Is Doing Business As Jersey Village Pharmacy-compounding.

The provider's business location address is:

17400 HIGHWAY 290 STE 400
JERSEY VILLAGE, TX
ZIP 77040-002
Phone: (281) 416-5800
Fax: (281) 416-5814

The provider's authorized official is Christine Coon .
The authorized official title is Pharmacy Manager and has the following contact phone number (713) 885-2039.

The enumeration date for this NPI number is 10/14/2013 and was last updated on 10/26/2013.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
13336M0002XPharmacyMail Order PharmacyNo
23336C0003XPharmacyCommunity/Retail PharmacyNo
33336S0011XPharmacySpecialty PharmacyNo
4332B00000XDurable Medical Equipment & Medical SuppliesNo
5333600000XPharmacyNo
63336C0004XPharmacyCompounding Pharmacy28723TEXASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
12142464OTHERPK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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