# MED SHOP PHARMACY INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861030504
- **Authorized official:** PATRICK WAYNE POWERS (PHARMACIST/OWNER)
- **Authorized official phone:** (903) 680-2600

## Contact information

- **Practice address:** 825 US HIGHWAY 271 N, GILMER, TX 75644-5580
- **Practice address phone:** (903) 680-2600
- **Practice address fax:** (903) 680-2605
- **Mailing address:** 825 US HIGHWAY 271 N, GILMER, TX 75644-5580
- **Mailing address phone:** (903) 680-2600
- **Mailing address fax:** (903) 680-2605

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 12/12/2019
- **Last updated:** 09/04/2024

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 148119 | — | TX |