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General NPI Number Information
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NPI Number | 1396804837
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Entity Type | Organization
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Legal Business Name | MGS PHARMACY INC
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Dates
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Enumeration Date | 12/08/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2505 W BELT LINE RD SUITE 600
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City | LANCASTER
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State | TX
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Zip | 75146-1930
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Country | US
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Telephone | 972-223-8787
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 765327
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City | DALLAS
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State | TX
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Zip | 75376-5327
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Country | US
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Telephone | 972-223-8787
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Fax |
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | MR. GABRIEL T SHONUGA
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Credential | B PHARM
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Telephone | 972-223-8787
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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 | 23290
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License Number State | TX
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