Healthcare Provider Details

I. General information

NPI: 1194714584
Provider Name (Legal Business Name): MEDICINE CHEST INSTITUTIONAL PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2005
Last Update Date: 09/22/2025
Certification Date: 09/22/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 MAIN ST STE 2
SULPHUR SPRINGS TX
75482-2762
US

IV. Provider business mailing address

3160 PARK CENTER DR
TYLER TX
75701-8482
US

V. Phone/Fax

Practice location:
  • Phone: 877-438-0770
  • Fax: 877-438-0827
Mailing address:
  • Phone: 903-630-6000
  • Fax: 903-594-4065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336I0012X
TaxonomyInstitutional Pharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number22484
License Number StateTX

VIII. Authorized Official

Name: CHAD MICHEL
Title or Position: CEO
Credential:
Phone: 903-630-6000