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General NPI Number Information
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NPI Number | 1275815334
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Entity Type | Organization
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Legal Business Name | MEDI-HEALTH PHARMACY GROUP LLC
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Dates
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Enumeration Date | 09/14/2011
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Last Update Date | 11/15/2011
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Provider Practice Location Address
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Address Line | 1200 KELLER PKWY STE 200
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City | KELLER
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State | TX
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Zip | 76248-3615
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Country | US
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Telephone | 682-593-0461
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Fax | 682-593-0460
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Provider Business Mailing Address
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Address Line | 1200 KELLER PKWY SUITE 200
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City | KELLER
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State | TX
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Zip | 76248-3615
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Country | US
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Telephone | 682-593-0461
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Fax | 682-593-0460
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Authorized Official
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Title or Position | PHARMACIST-IN-CHARGE
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Name | NIRAV PATEL
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Credential |
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Telephone | 973-698-0143
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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 | 27642
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License Number State | TX
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