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General NPI Number Information
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NPI Number | 1568762755
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Entity Type | Organization
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Legal Business Name | MEDIC ONE PHARMACY
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Dates
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Enumeration Date | 10/22/2010
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Last Update Date | 05/03/2016
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Provider Practice Location Address
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Address Line | 1701 FAIRWAY DR SUITE 3A
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City | ALVIN
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State | TX
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Zip | 77511-4661
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Country | US
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Telephone | 281-824-0222
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Fax |
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Provider Business Mailing Address
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Address Line | 1701 FAIRWAY DR SUITE 3A
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City | ALVIN
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State | TX
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Zip | 77511-4661
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Country | US
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Telephone | 281-824-0222
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Fax |
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Authorized Official
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Title or Position | PHARMACIST/OWNER
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Name | DR. DESIREE COLEMAN
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Credential |
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Telephone | 281-824-0222
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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 | 27164
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License Number State | TX
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