MEDICARE: MID VALLEY PHARMACY LLP

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
1	332B00000X	Durable Medical Equipment & Medical Supplies	5436770001	TX
2	333600000X	Pharmacy	5436770001	TX

General Provider Information

NPI Number	:	1407848112
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MID VALLEY PHARMACY LLP

Provider Business Mailing Address
First Line	:	400 E EXPRESSWAY 83
Second Line	:
City	:	MERCEDES
State	:	TX
Zip	:	78570-2700
Country	:	US
Telephone Number	:	956-565-4111
Fax Number	:	956-565-2190

Provider Business Practice Location Address
First Line	:	400 E EXPRESSWAY 83
Second Line	:
City	:	MERCEDES
State	:	TX
Zip	:	78570-2700
Country	:	US
Telephone Number	:	956-565-4111
Fax Number	:	956-565-2190

Authorized Official
Title or Position	:	RPH/OWNER
Name	:	MR. JOHN HINKLE
Credential	:	RPH
Telephone Number	:	956-565-4111

Provider Enumeration Date	:	08/18/2005
Last Update Date	:	03/26/2024

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Directions to “MID VALLEY PHARMACY LLP ” Practice Location

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