Healthcare Provider Details

I. General information

NPI: 1609860725
Provider Name (Legal Business Name): JOHN M. MOHRMANN, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/02/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1303 MCCULLOUGH AVE
SAN ANTONIO TX
78212-5609
US

IV. Provider business mailing address

415 CAMDEN ST
SAN ANTONIO TX
78215-1923
US

V. Phone/Fax

Practice location:
  • Phone: 210-227-7207
  • Fax: 210-223-5272
Mailing address:
  • Phone: 210-224-1371
  • Fax: 210-223-5272

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code333600000X
TaxonomyPharmacy
License Number10309
License Number StateTX

VIII. Authorized Official

Name: MRS. MATTIE TRAWICK
Title or Position: DIRECTOR
Credential:
Phone: 210-224-1371