Galveston Specialty Pharmacy

LBN: Fiesta Lifecare Pharmacy 3 Llc
Galveston Specialty Pharmacy is an health care organization with primary practice located at 707 23Rd St Suite F, Galveston TX 77550. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Fiesta Lifecare Pharmacy 3 Llc can be contacted via phone (409) 877-7029, or through Kalidindi, Prem via phone (917) 769-8014.

Contact Information

Primary practice address
707 23Rd St Suite F Galveston TX 77550
Phone: (409) 877-7029
Fax: (281) 549-5957
Website:
Map and Directions
Authorized official contact:
Name: Kalidindi, Prem
Phone: (917) 769-8014

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 31265 Texas

Profile Details

NPI number 1174065643
LBN Legal business name Fiesta Lifecare Pharmacy 3 Llc
DBA Doing business as Galveston Specialty Pharmacy
Authorized official Kalidindi, Prem
Entity Organization
Organization subpart 1 No
Enumeration date Nov 15th, 2016
Last updated Dec 13th, 2019 - about 5 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174065643 NPPES
Texas MEDICAID 150052
Texas Other 2164062
Texas MEDICAID 14594

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