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General NPI Number Information
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NPI Number | 1194906446
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Entity Type | Organization
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Legal Business Name | MEDICINE PLACE INC 1008 LAMAR ST SWEETWATER TX
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Dates
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Enumeration Date | 11/15/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1410 LAMAR ST
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City | SWEETWATER
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State | TX
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Zip | 79556-7124
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Country | US
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Telephone | 325-235-4366
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Fax | 325-236-6800
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Provider Business Mailing Address
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Address Line | 1410 LAMAR ST
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City | SWEETWATER
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State | TX
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Zip | 79556-7124
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Country | US
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Telephone | 325-235-4366
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Fax | 325-236-6800
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Authorized Official
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Title or Position | DME MANAGER
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Name | SHERRY WEEMS
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Credential |
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Telephone | 325-235-4366
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332BP3500X
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Taxonomy Name | Parenteral & Enteral Nutrition Supplies (DME)
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License Number |
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 332BX2000X
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Taxonomy Name | Oxygen Equipment & Supplies (DME)
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License Number |
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License Number State | TX
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