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General NPI Number Information
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NPI Number | 1295033231
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Entity Type | Organization
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Legal Business Name | ZKMSH HOLDINGS
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Dates
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Enumeration Date | 02/28/2011
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Last Update Date | 02/28/2011
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Provider Practice Location Address
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Address Line | 1402 N GRANT ST STE C
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City | ROMA
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State | TX
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Zip | 78584-5412
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Country | US
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Telephone | 956-566-0696
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Fax | 956-849-1068
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Provider Business Mailing Address
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Address Line | 401 ZINNIA AVE
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City | MCALLEN
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State | TX
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Zip | 78504-2859
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Country | US
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Telephone | 956-566-0696
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Fax | 956-849-1068
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Authorized Official
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Title or Position | CEO
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Name | MICHAEL SEBHAT HAGOS
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Credential | RPH
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Telephone | 956-566-0696
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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 | TX
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