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Organization
FIFTY 50 MEDICAL LLC
Active
Organization
FIFTY 50 MEDICAL LLC
Active
Other names
Fifty50 Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MAXINE WILSON (GM)
(972) 243-2727
Entity
Organization
Contact information
Practice address
1411 E SANDY LAKE RD STE 120, COPPELL, TX 75019-7947
(972) 243-2727
(972) 243-3111
Mailing address
1411 E SANDY LAKE RD STE 120, COPPELL, TX 75019-7947
(972) 243-2727
(972) 243-3111
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
26217
TX
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
—
NULL
Other
Enumeration date
11/12/2008
Last updated
05/08/2023
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