=====================================================
General NPI Number Information
=====================================================
NPI Number | 1427117340
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DOCS PRESCRIPTION PHARMACY INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/06/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 11826 GALLIA PIKE
-----------------------------------------------------
City | WHEELERSBURG
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45694
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 740-574-9953
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 11826 GALLIA PIKE
-----------------------------------------------------
City | WHEELERSBURG
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 45694
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 740-574-9953
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MR. LARRY A. MULLENS
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 740-574-9953
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number | HMEL 11087
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------