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General NPI Number Information
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NPI Number | 1831702083
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Entity Type | Organization
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Legal Business Name | MAYTA HEALTH SYSTEMS LLC
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Dates
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Enumeration Date | 08/27/2020
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Last Update Date | 02/24/2022
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Provider Practice Location Address
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Address Line | 2101 N MIDLAND DR STE 14B
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City | MIDLAND
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State | TX
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Zip | 79707-5507
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Country | US
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Telephone | 432-237-3010
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Fax | 432-237-3020
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Provider Business Mailing Address
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Address Line | 610 N FORT WORTH ST
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City | MIDLAND
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State | TX
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Zip | 79701-4873
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | SETOR AKATI
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Credential |
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Telephone | 432-237-3010
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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