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General NPI Number Information
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NPI Number | 1407848112
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Entity Type | Organization
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Legal Business Name | MID VALLEY PHARMACY LLP
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Dates
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Enumeration Date | 08/18/2005
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Last Update Date | 03/26/2024
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Provider Practice Location Address
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Address Line | 400 E EXPRESSWAY 83
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City | MERCEDES
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State | TX
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Zip | 78570-2700
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Country | US
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Telephone | 956-565-4111
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Fax | 956-565-2190
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Provider Business Mailing Address
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Address Line | 400 E EXPRESSWAY 83
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City | MERCEDES
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State | TX
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Zip | 78570-2700
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Country | US
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Telephone | 956-565-4111
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Fax | 956-565-2190
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Authorized Official
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Title or Position | RPH/OWNER
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Name | MR. JOHN HINKLE
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Credential | RPH
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Telephone | 956-565-4111
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 5436770001
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 5436770001
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License Number State | TX
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