| Organization Name: | PHARMEDIUM SERVICES LLC |
| NPI Number: | 1013178656 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | RICHARD DILLOW (PHCY MANG) |
| Mailing Address: | 12620 W Airport Blvd Ste 130 Sugar Land |
| State: | TX US |
| Postal Code: | 774786199 |
| Phone Number: | 2814911900 |
| Fax Number: | 8663806918 |
| NPI Enumeration Date: | 06/17/2008 |
| NPI Last Update Date: | 06/17/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 3336C0004X |
| License Number: | 22931 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | TX |
| Taxonomy Type: | Suppliers |
| Taxonomy Classification: | Pharmacy |
| Taxonomy Specialization: | Compounding Pharmacy |
| Taxonomy Definition: | A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner |