Organization
MEDI STAT RX LLC
Active
Other names
MEDI STAT RX
Organization subpart
No
Provider details
NPI number
Authorized official
JANAK PATEL (PRESIDENT)
(972) 247-9101
Entity
Organization
Contact information
Practice address
500 W JEFFERSON BLVD, STE A, DALLAS, TX 75208-4722
(214) 946-3822
(214) 946-8300
Mailing address
500 W JEFFERSON BLVD, STE A, DALLAS, TX 75208-4722
(214) 946-3822
(214) 946-8300
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
23238
TX
3336M0002X
Mail Order Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
145477
—
TX
01
—
4535588
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
06/22/2006
Last updated
06/16/2010
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