Healthcare Provider Details

I. General information

NPI: 1750468625
Provider Name (Legal Business Name): MCMAKIN INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/31/2006
Last Update Date: 10/21/2022
Certification Date: 10/21/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4225 GLADYS AVE
BEAUMONT TX
77706-3644
US

IV. Provider business mailing address

4225 GLADYS AVE
BEAUMONT TX
77706-3644
US

V. Phone/Fax

Practice location:
  • Phone: 409-898-0717
  • Fax: 409-899-2977
Mailing address:
  • Phone: 409-898-0717
  • Fax: 409-899-2977

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332BP3500X
TaxonomyParenteral & Enteral Nutrition Supplies (DME)
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number26206
License Number StateTX
# 4
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code3336H0001X
TaxonomyHome Infusion Therapy Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: ARTHUR MCMAKIN
Title or Position: PRESIDENT PIC
Credential: B.S. PHARMACY
Phone: 409-898-0717