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General NPI Number Information
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NPI Number | 1841670817
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Entity Type | Organization
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Legal Business Name | GASTROINTESTINAL ASSOCIATES, PA
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Dates
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Enumeration Date | 06/04/2015
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Last Update Date | 09/17/2024
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Provider Practice Location Address
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Address Line | 2510 LAKELAND DR. SUITE 150
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City | FLOWOOD
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State | MS
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Zip | 39232
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Country | US
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Telephone | 601-326-3516
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Fax | 601-326-6470
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Provider Business Mailing Address
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Address Line | 1620 W. NORTHWEST HIGHWAY SUITE 100
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City | GRAPEVINE
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State | TX
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Zip | 76051
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Country | US
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Telephone | 817-572-0009
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Fax | 817-572-0221
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Authorized Official
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Title or Position | MANAGING OFFICER
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Name | MR. TODD WARREN
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Credential |
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Telephone | 817-572-0009
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | 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 | 3336S0011X
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Taxonomy Name | Specialty Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 14337
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License Number State | MS
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