| NPI | 1134556756 |
|---|---|
| Doing Business As | GRAND AVENUE PHARMACY |
| Entity Type | Organization |
| Authorized Contact | CHRIS ADLAKHA Owner 512-377-1999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: TX 28813) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies (Licence: TX 28813) |
| 332BP3500X Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition (Licence: TX 28813) | |
| 333600000X Pharmacy | |
| 3336C0004X Pharmacy, Compounding Pharmacy | |
| 3336H0001X Pharmacy, Home Infusion Therapy Pharmacy (Licence: TX 28813) | |
| Enumeration Date | 2013-09-27 |
| Last Update Date | 2018-05-17 |