Provider Demographics
NPI:1083824395
Name:MAXIMUM PHARMACY 3
Entity type:Organization
Organization Name:MAXIMUM PHARMACY 3
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST-IN-CHARGE
Authorized Official - Prefix:MR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:WITT
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:713-731-1919
Mailing Address - Street 1:4115 REED RD
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77051-2711
Mailing Address - Country:US
Mailing Address - Phone:713-731-1919
Mailing Address - Fax:713-731-7500
Practice Address - Street 1:4115 REED RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77051-2711
Practice Address - Country:US
Practice Address - Phone:713-731-1919
Practice Address - Fax:713-731-7500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-23
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX32229183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX144736Medicaid