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General NPI Number Information
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NPI Number | 1144544685
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Entity Type | Organization
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Legal Business Name | KINDLE MAYBERRY INVESTMENT GROUP INC
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Dates
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Enumeration Date | 03/25/2010
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Last Update Date | 05/16/2018
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Provider Practice Location Address
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Address Line | 1317 HWY 175 STE 800
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City | CRANDALL
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State | TX
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Zip | 75114
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Country | US
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Telephone | 972-427-6442
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Fax | 972-427-6470
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Provider Business Mailing Address
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Address Line | PO BOX 100
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City | CRANDALL
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State | TX
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Zip | 75114-0100
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Country | US
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Telephone | 903-972-6442
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | GARY MAYBERRY
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Credential |
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Telephone | 972-427-6442
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 26860
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License Number State | TX
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