Provider Demographics
NPI:1548668106
Name:HHP #4 PHARMACY, LLC.
Entity type:Organization
Organization Name:HHP #4 PHARMACY, LLC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:GEORGIO
Authorized Official - Middle Name:
Authorized Official - Last Name:DENOBREGA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:832-589-5668
Mailing Address - Street 1:2811 TEAGUE RD
Mailing Address - Street 2:1303
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77080-2502
Mailing Address - Country:US
Mailing Address - Phone:346-204-4576
Mailing Address - Fax:346-204-4573
Practice Address - Street 1:2811 TEAGUE RD
Practice Address - Street 2:1303
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77080-2502
Practice Address - Country:US
Practice Address - Phone:346-204-4576
Practice Address - Fax:346-204-4573
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-15
Last Update Date:2017-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
TX296453336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2148998OtherPK