Organization Name: | MEDEQUIP HEALTH CORP |
NPI Number: | 1063669315 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KYLE W PULLIAM (PHARMACIST) |
Mailing Address: | 465 N Belair Rd 1a2 Evans |
State: | GA US |
Postal Code: | 308093188 |
Phone Number: | 7068555502 |
Fax Number: | 7068542425 |
NPI Enumeration Date: | 08/19/2008 |
NPI Last Update Date: | 08/19/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 3336C0004X |
License Number: | PHRE009484 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
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 |