Organization Active NPI

Hancock Pharmacies Inc

Doing business as Medic Pharmacy

  • Community/Retail Pharmacy
  • Houston, TX
National Provider Identifier
1710923602
Registry record updated Dec 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
12563 Issued in TX
Legal business name
HANCOCK PHARMACIES INC
Doing business as
Medic Pharmacy
Practice address
4040 S Braeswood Blvd
Houston, TX 77025-3304
Phone
(713) 666-6353
Fax
(713) 666-2831
NPI assigned
Jun 21, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 20, 2023

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

Authorized official

Name
Gurbhej Cheema, PHARMDNPI 1306174388
Title
President
Phone
(713) 666-6353

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility Supplies (DME) 332BN1400X
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 12563 TX Primary
Long Term Care Pharmacy 3336L0003X
Mail Order Pharmacy 3336M0002X

Addresses

Primary practice location

4040 S Braeswood Blvd
Houston, TX 77025-3304

Mailing address

4040 S Braeswood Blvd
Houston, TX 77025-3304
Phone (713) 666-6353

Other identifiers 2

IdentifierTypeStateIssuer
144804MedicaidTX
2097174OtherPK

Other names 1

  • MEDIC PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240111002333 TX Part B Supplier - Pharmacy 5698896272 Practice locations: Houston, TX

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
45D2209793Medic Pharmacy4040 S Braeswood Blvd, Houston, TX 77025Certificate of waiverJan 15, 2027

National Provider Directory

National Provider Directory

Locations

4040 S Braeswood Blvd
Houston, TX 77025
Phone (713) 666-6353

539 S Mason Rd
#B
Katy, TX 77450
Phone (281) 829-2727

Practitioners & affiliated clinicians

Practitioners 3

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

NPI Registry JSON

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703030400000",
    "number": "1710923602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4040 S BRAESWOOD BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770253304",
            "telephone_number": "713-666-6353",
            "fax_number": "713-666-2831"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4040 S BRAESWOOD BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770253304",
            "telephone_number": "713-666-6353",
            "fax_number": "713-666-2831"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HANCOCK PHARMACIES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-21",
        "last_updated": "2023-12-20",
        "certification_date": "2023-12-20",
        "status": "A",
        "authorized_official_last_name": "CHEEMA",
        "authorized_official_first_name": "GURBHEJ",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "713-666-6353",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "332BN1400X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Nursing Facility 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": "TX",
            "license": "12563",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "144804",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2097174",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MEDIC PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MEDIC PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Houston, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.