Provider Demographics
NPI:1134983588
Name:OBEN PHARMACY GROUP LLC
Entity type:Organization
Organization Name:OBEN PHARMACY GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMD
Authorized Official - Prefix:
Authorized Official - First Name:BESSEM
Authorized Official - Middle Name:
Authorized Official - Last Name:OBEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-235-0807
Mailing Address - Street 1:4421 STATE HIGHWAY 6 S STE 300
Mailing Address - Street 2:
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77845-6176
Mailing Address - Country:US
Mailing Address - Phone:979-330-5216
Mailing Address - Fax:855-201-8501
Practice Address - Street 1:4421 STATE HIGHWAY 6 S STE 300
Practice Address - Street 2:
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77845-6176
Practice Address - Country:US
Practice Address - Phone:979-330-5216
Practice Address - Fax:855-201-8501
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-07
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy