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NPI Code Detail

MEDICARE: THE EDDICK CORPORATION

MEDICARE: THE EDDICK CORPORATION
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1332B00000XDurable Medical Equipment & Medical Supplies
2333600000XPharmacy
3261Q00000XClinic/Center
43336L0003XLong Term Care Pharmacy
53336C0003XCommunity/Retail Pharmacy27260TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12128266OTHERPK

General Provider Information

NPI Number : 1003890369
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE EDDICK CORPORATION
Provider Business Mailing Address
First Line : 1015 HILLCREST DR
Second Line : STE B
City : VERNON
State : TX
Zip : 76384-3100
Country : US
Telephone Number : 940-552-9501
Fax Number : 940-552-2075
Provider Business Practice Location Address
First Line : 1015 HILLCREST DR
Second Line : STE B
City : VERNON
State : TX
Zip : 76384-3100
Country : US
Telephone Number : 940-552-9501
Fax Number : 940-552-2075
Authorized Official
Title or Position : PRESIDENT
Name : ADAM BAYER
Credential :
Telephone Number : 940-552-9501
Provider Enumeration Date : 12/01/2005
Last Update Date : 07/17/2024

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Directions to “THE EDDICK CORPORATION ” Practice Location

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