Healthcare Provider Details

I. General information

NPI: 1982778452
Provider Name (Legal Business Name): MED CARE PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/17/2006
Last Update Date: 01/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

213 W SCURRY ST STE C
DAINGERFIELD TX
75638-1661
US

IV. Provider business mailing address

PO BOX 715
DAINGERFIELD TX
75638-0715
US

V. Phone/Fax

Practice location:
  • Phone: 903-645-5933
  • Fax: 903-645-5934
Mailing address:
  • Phone: 903-645-5933
  • Fax: 903-645-5934

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number18845
License Number StateTX

VIII. Authorized Official

Name: JEREL KERBY
Title or Position: PRESIDENT PHARMACIST
Credential:
Phone: 903-645-5933