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NPI Code Detail

MEDICARE: FARMACIA DE MEDICIA INC

MEDICARE: FARMACIA DE MEDICIA INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13336C0002XClinic Pharmacy
23336L0003XLong Term Care Pharmacy
3333600000XPharmacy
43336C0003XCommunity/Retail Pharmacy23660TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
22090578OTHERPK

General Provider Information

NPI Number : 1740377944
Entity Type Code : Organization
Provider Name (Legal Business Name) : FARMACIA DE MEDICIA INC
Provider Business Mailing Address
First Line : 2715 FANNIN ST
Second Line :
City : HOUSTON
State : TX
Zip : 77002-9217
Country : US
Telephone Number : 713-838-8110
Fax Number : 713-838-8797
Provider Business Practice Location Address
First Line : 2715 FANNIN ST
Second Line :
City : HOUSTON
State : TX
Zip : 77002-9217
Country : US
Telephone Number : 713-838-8110
Fax Number : 713-838-8797
Authorized Official
Title or Position : PRESIDENT
Name : CEDRIC WASHINGTON
Credential : CPHT
Telephone Number : 281-330-5044
Provider Enumeration Date : 10/07/2006
Last Update Date : 06/10/2015

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Directions to “FARMACIA DE MEDICIA INC ” Practice Location

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