Provider Demographics
NPI:1902948409
Name:FLEMING ENTERPRISES INC
Entity Type:Organization
Organization Name:FLEMING ENTERPRISES INC
Other - Org Name:GENESIS PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:R
Authorized Official - Last Name:FLEMING
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:281-804-6770
Mailing Address - Street 1:2322 WREN MEADOW RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:TX
Mailing Address - Zip Code:77469-2353
Mailing Address - Country:US
Mailing Address - Phone:281-342-3413
Mailing Address - Fax:281-344-8999
Practice Address - Street 1:902 FM 359 RD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:TX
Practice Address - Zip Code:77469-2010
Practice Address - Country:US
Practice Address - Phone:281-344-8600
Practice Address - Fax:281-344-8999
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX251113336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
4508795OtherNCPDP #
TX144898Medicaid