Gerald Endohabe Andu-Anzah, RPH
Individual provider Active NPI Pharmacist · Mount Pleasant, TX
NPI 1104421841 · NPPES record last updated Dec 1, 2020
Key facts
- NPI
- 1104421841
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 63706 (TX)
- Practice address
- 601 S Jefferson Ave
Mount Pleasant, TX 75455-4836 - Phone
- (240) 559-7354
- NPI assigned
- Dec 1, 2020
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 63706 | TX | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 63706 | TX | Yes |
Addresses
Primary practice location
601 S Jefferson Ave
Mount Pleasant, TX 75455-4836
Mailing address
118 Acadia LN
Forney, TX 75126-4212
Phone (240) 559-7354
Other providers in Mount Pleasant, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 1, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.