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General NPI Number Information
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NPI Number | 1184099020
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Entity Type | Organization
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Legal Business Name | PHARMACY AND SURGICAL SUPPLIES INC
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Dates
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Enumeration Date | 12/03/2015
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Last Update Date | 06/15/2021
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Provider Practice Location Address
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Address Line | 10300 SCYENE RD # 102
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City | DALLAS
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State | TX
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Zip | 75227-4932
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Country | US
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Telephone | 469-283-8878
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Fax | 469-375-5385
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Provider Business Mailing Address
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Address Line | 10300 SCYENE RD # 102
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City | DALLAS
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State | TX
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Zip | 75227-4932
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Country | US
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Telephone | 469-283-8878
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Fax | 469-375-5385
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Authorized Official
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Title or Position | MEMBER
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Name | MITESH MARADIA
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Credential |
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Telephone | 972-693-8079
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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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 | 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 #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 30350
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License Number State | TX
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