Organization
MEDSOURCE ESSENTIALS LLC
Active
Organization
MEDSOURCE ESSENTIALS LLC
Active
Other names
MedSource Essentials Group
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOE MITCHELL PHARMD (OWNER/PIC)
(832) 392-7031
Entity
Organization
Contact information
Practice address
8820 WILL CLAYTON PKWY STE G, HUMBLE, TX 77338-5836
(832) 644-1250
Mailing address
18335 CAPE LOOKOUT WAY, HUMBLE, TX 77346-4057
(832) 392-7031
(281) 570-2580
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336L0003X
Long Term Care Pharmacy
—
—
3336M0002X
Mail Order Pharmacy
—
—
Other
Enumeration date
05/27/2021
Last updated
08/02/2021
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