Organization
CARSAN INC
Active
Other names
MEDICINE SHOPPE
Organization subpart
No
Provider details
NPI number
Authorized official
DENA FERMAN (THIRD PARTY PLAN COORDINATOR)
(314) 993-6000
Entity
Organization
Contact information
Practice address
8111 CYPRESSWOOD DR, SUITE 107, SPRING, TX 77379-7185
(281) 655-0110
(281) 655-0045
Mailing address
8111 CYPRESSWOOD DR, SUITE 107, SPRING, TX 77379-7185
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
18211
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
144635
—
TX
01
—
4501498
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
02/21/2007
Last updated
09/25/2007
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