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General NPI Number Information
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NPI Number | 1215081666
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Entity Type | Organization
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Legal Business Name | MEDICAL DISCOUNT PHARMACY LP
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 06/20/2008
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Provider Practice Location Address
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Address Line | 1316 7TH ST
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City | ROSENBERG
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State | TX
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Zip | 77471-3531
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Country | US
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Telephone | 281-232-3940
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Fax | 832-595-1203
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Provider Business Mailing Address
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Address Line | PO BOX 1047
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City | RICHMOND
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State | TX
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Zip | 77406-0027
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MR. BRUCE GINGRICH
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Credential |
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Telephone | 281-232-3940
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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 | 25402
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License Number State | TX
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