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NPI Code Detail

MEDICARE: MSCARTER RX INC

MEDICARE: MSCARTER RX INC
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
1333600000XPharmacy
23336L0003XLong Term Care Pharmacy28337TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
12136461OTHERPK

General Provider Information

NPI Number : 1659629491
Entity Type Code : Organization
Provider Name (Legal Business Name) : MSCARTER RX INC
Provider Business Mailing Address
First Line : 3845 SPID DR # B
Second Line :
City : CORPUS CHRISTI
State : TX
Zip : 78415-2919
Country : US
Telephone Number : 361-452-2051
Fax Number :
Provider Business Practice Location Address
First Line : 3845 SPID DR # B
Second Line :
City : CORPUS CHRISTI
State : TX
Zip : 78415-2919
Country : US
Telephone Number : 361-452-2051
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MARK CARTER
Credential :
Telephone Number : 361-452-2051
Provider Enumeration Date : 08/28/2012
Last Update Date : 08/26/2015

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