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General NPI Number Information
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NPI Number | 1063890911
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Entity Type | Organization
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Legal Business Name | MEKNELL INC
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Dates
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Enumeration Date | 05/12/2015
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Last Update Date | 10/29/2020
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Provider Practice Location Address
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Address Line | 101 E CORPORATE DR STE 130
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City | LEWISVILLE
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State | TX
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Zip | 75067-6601
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Country | US
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Telephone | 972-299-8990
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Fax |
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Provider Business Mailing Address
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Address Line | 101 E CORPORATE DR SUITE 220
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City | LEWISVILLE
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State | TX
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Zip | 75067-6603
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Country | US
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Telephone | 972-299-8990
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | EMMANUEL DEREK OFORI
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Credential |
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Telephone | 972-468-8788
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 29918
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License Number State | TX
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