Organization Name: | MEDICINE PLACE INC |
NPI Number: | 1194906446 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | TEDDY LEE BASYE (PHARMACIST) |
Mailing Address: | 1410 Lamar St Sweetwater |
State: | TX US |
Postal Code: | 795567124 |
Phone Number: | 3252354366 |
Fax Number: | 3252366800 |
NPI Enumeration Date: | 11/15/2007 |
NPI Last Update Date: | 03/09/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 332BP3500X |
License Number: | ========= |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | TX |
Taxonomy Type: | Suppliers |
Taxonomy Classification: | Durable Medical Equipment & Medical Supplies |
Taxonomy Specialization: | Parenteral & Enteral Nutrition |
Taxonomy Definition: |