Jersey Village Pharmacy LLC

Primary specialty

Compounding PharmacyTaxonomy code 3336C0004X

License

28723 Issued in TX

Legal business name

JERSEY VILLAGE PHARMACY LLC

Practice address

17400 Highway 290 Ste 400
Jersey Village, TX 77040-1002

Phone

(281) 416-5800

Fax

(281) 416-5814

NPI assigned

Oct 14, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Christine CoonNPI 1528496296

Title

Pharmacy Manager

Phone

(713) 885-2039

Specialties & licenses 6

Addresses

Other identifiers 1

Other names 1

• Jersey Village Pharmacy-Compounding Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Christine Coon

  • Pharmacist
  • Houston, TX
  • NPI 1528496296
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1381708800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1382745600000",
    "number": "1396172128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17400 HIGHWAY 290 STE 400",
            "city": "JERSEY VILLAGE",
            "state": "TX",
            "postal_code": "770401002",
            "telephone_number": "281-416-5800",
            "fax_number": "281-416-5814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17400 HIGHWAY 290 STE 400",
            "city": "JERSEY VILLAGE",
            "state": "TX",
            "postal_code": "770401002",
            "telephone_number": "281-416-5800",
            "fax_number": "281-416-5814"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JERSEY VILLAGE PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-10-14",
        "last_updated": "2013-10-26",
        "status": "A",
        "authorized_official_last_name": "COON",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "PHARMACY MANAGER",
        "authorized_official_telephone_number": "713-885-2039"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "TX",
            "license": "28723",
            "primary": true
        },
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2142464",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jersey Village Pharmacy-Compounding",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Houston Care Partners, L.L.C.
• Huong Anh Huynh, DPT
• Imran R Baig OD PLLC
• Christina Itata, M.D.
• Catherine Jenkins Boyd
• Caitlin Marie Johnston, OTR/L
• Jones ER Physicians Staffing Inc
• Gigi Joseph, BOCPO,LPO
• Elizabeth M Kenska, PT
• James Hoyt Kern, MD

• Compounding Pharmacy in Jersey Village, TX
• Providers in Jersey Village, TX by specialty
• Compounding Pharmacy in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.