Healthcare Provider Details

I. General information

NPI: 1992791750
Provider Name (Legal Business Name): MATTHEWSON DRUG CO INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2005
Last Update Date: 02/05/2025
Certification Date: 02/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

717 S WASHINGTON AVE
MARSHALL TX
75670-5337
US

IV. Provider business mailing address

717 S WASHINGTON AVE
MARSHALL TX
75670-5337
US

V. Phone/Fax

Practice location:
  • Phone: 903-935-2351
  • Fax: 903-938-6742
Mailing address:
  • Phone: 903-935-2351
  • Fax: 903-938-6742

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number12375
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: BRIAN BATES
Title or Position: OWNER/PHARMACIST
Credential: RPH
Phone: 903-935-2351