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Provider Information for 1689065138


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BLACKSEA PHARMACEUTICALS INC

Other Names:  
Doing Business As: 
MEDICX PHARMACY

Organization Subpart: NO

NPI: 1689065138
Last Updated: 2023-11-15
Certification Date: 2023-11-15

Details

NameValue
NPI1689065138
Enumeration Date2015-02-05
NPI TypeNPI-2 Organization
StatusActive
Authorized Official Information Name: AKWASI AMANKWAAH
Title: Officer
Phone: 2815946027
Mailing Address 8433 FM 1464 RD STE S
RICHMOND, TX 77407-1103
United States

Phone: 281-594-6027 | Fax:
 
Primary Practice Address 8433 FM 1464 RD STE S
RICHMOND, TX 77407-1103
United States

Phone: 281-594-6027 | Fax:
 
Secondary Practice Address(es)
Health Information Exchange
Endpoint TypeEndpointEndpoint DescriptionUseContent TypeAffiliationEndpoint Location
Other Identifiers
IssuerStateNumberOther Issuer
MEDICAIDTX149516
Other (non-Medicare)2159709PK
Taxonomy
Primary TaxonomySelected TaxonomyStateLicense Number
Yes 3336C0003X - Pharmacy - Community/Retail PharmacyTX29751